Role of surgeon experience in the outcome of transurethral resection of bladder tumors
Purpose: The purpose of the study is to assess the quality of transurethral resection of bladder tumors (TURBTs) performed by “senior” and “junior” urologists in terms of detrusor muscle (DM) presence at the initial resection and presence of missed and residual tumors at second-look TURBT. Patients...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Urology Annals |
| Subjects: | |
| Online Access: | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2020;volume=12;issue=4;spage=341;epage=346;aulast=Ali |
| _version_ | 1818341197216743424 |
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| author | Mohamed Hassan Ali Ahmed Eltobgy Iman Yehia Ismail Ammar Ghobish |
| author_facet | Mohamed Hassan Ali Ahmed Eltobgy Iman Yehia Ismail Ammar Ghobish |
| author_sort | Mohamed Hassan Ali |
| collection | DOAJ |
| description | Purpose: The purpose of the study is to assess the quality of transurethral resection of bladder tumors (TURBTs) performed by “senior” and “junior” urologists in terms of detrusor muscle (DM) presence at the initial resection and presence of missed and residual tumors at second-look TURBT.
Patients and Methods: An analytic prospective cohort study included 171 patients with stage T1 and Ta bladder cancer who had undergone an initial TURBT. Patients were divided into two groups according to surgeon experience. Group 1 (116 patients) operated on by senior surgeons (consultants and trainees in year 5 or 6) and Group 2 (55 patients) operated on by junior surgeons (trainees below year 5). All patients underwent second-look TURBT (by a senior urologist) within 2–6 weeks after the initial resection. The outcome of the initial and re-TURBT represented with regard to the surgeon experience.
Results: There is a statistically significant difference between senior and junior surgeons regarding the presence or absence of DM in the initial resection (P = 0.001). A significant relation between the presence of residual tumors in re thermodynamic uncertainty relation (TUR) in relation to the initial operator was found (P = 0.03). Re-TURBT of patients in Group 1 (initially operated on by experienced surgeons) revealed that 57.7% had tumor-free resection while 36.2% had residual tumors, 5.2% had missed lesion and only 0.9% had concurrent residual and missed tumors. In contrast, from Group 2 (55 patients operated by junior surgeons) 47.3% had residual tumor, 21.8% had missed lesions, and 9.1% had concurrent residual and missed tumors in re-TUR.
Conclusions: Nonmuscle invasive bladder cancer treated with TURBT should be managed as any other major oncologic procedure. TURBT should be performed by an experienced surgeon or with very close supervision when done by training urologist. |
| first_indexed | 2024-12-13T15:54:58Z |
| format | Article |
| id | doaj.art-ea3c1c559be445b3911ff21be5c7b03d |
| institution | Directory Open Access Journal |
| issn | 0974-7796 0974-7834 |
| language | English |
| last_indexed | 2024-12-13T15:54:58Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Urology Annals |
| spelling | doaj.art-ea3c1c559be445b3911ff21be5c7b03d2022-12-21T23:39:20ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342020-01-0112434134610.4103/UA.UA_138_19Role of surgeon experience in the outcome of transurethral resection of bladder tumorsMohamed Hassan AliAhmed EltobgyIman Yehia IsmailAmmar GhobishPurpose: The purpose of the study is to assess the quality of transurethral resection of bladder tumors (TURBTs) performed by “senior” and “junior” urologists in terms of detrusor muscle (DM) presence at the initial resection and presence of missed and residual tumors at second-look TURBT. Patients and Methods: An analytic prospective cohort study included 171 patients with stage T1 and Ta bladder cancer who had undergone an initial TURBT. Patients were divided into two groups according to surgeon experience. Group 1 (116 patients) operated on by senior surgeons (consultants and trainees in year 5 or 6) and Group 2 (55 patients) operated on by junior surgeons (trainees below year 5). All patients underwent second-look TURBT (by a senior urologist) within 2–6 weeks after the initial resection. The outcome of the initial and re-TURBT represented with regard to the surgeon experience. Results: There is a statistically significant difference between senior and junior surgeons regarding the presence or absence of DM in the initial resection (P = 0.001). A significant relation between the presence of residual tumors in re thermodynamic uncertainty relation (TUR) in relation to the initial operator was found (P = 0.03). Re-TURBT of patients in Group 1 (initially operated on by experienced surgeons) revealed that 57.7% had tumor-free resection while 36.2% had residual tumors, 5.2% had missed lesion and only 0.9% had concurrent residual and missed tumors. In contrast, from Group 2 (55 patients operated by junior surgeons) 47.3% had residual tumor, 21.8% had missed lesions, and 9.1% had concurrent residual and missed tumors in re-TUR. Conclusions: Nonmuscle invasive bladder cancer treated with TURBT should be managed as any other major oncologic procedure. TURBT should be performed by an experienced surgeon or with very close supervision when done by training urologist.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2020;volume=12;issue=4;spage=341;epage=346;aulast=Aliqualitysurgeon experiencetransurethral resection of bladder tumors |
| spellingShingle | Mohamed Hassan Ali Ahmed Eltobgy Iman Yehia Ismail Ammar Ghobish Role of surgeon experience in the outcome of transurethral resection of bladder tumors Urology Annals quality surgeon experience transurethral resection of bladder tumors |
| title | Role of surgeon experience in the outcome of transurethral resection of bladder tumors |
| title_full | Role of surgeon experience in the outcome of transurethral resection of bladder tumors |
| title_fullStr | Role of surgeon experience in the outcome of transurethral resection of bladder tumors |
| title_full_unstemmed | Role of surgeon experience in the outcome of transurethral resection of bladder tumors |
| title_short | Role of surgeon experience in the outcome of transurethral resection of bladder tumors |
| title_sort | role of surgeon experience in the outcome of transurethral resection of bladder tumors |
| topic | quality surgeon experience transurethral resection of bladder tumors |
| url | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2020;volume=12;issue=4;spage=341;epage=346;aulast=Ali |
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