Category: Endoscopic

MP30-14 - How Effective Can Routine Transurethral En Bloc Resection of Bladder Tumour Be Regardless of Tumour Size?

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

The feasibility of transurethral en bloc resection of bladder tumour (ERBT) is often limited by the size of the bladder tumour. We hereby report our experience of ERBT for all patients regardless of tumour size.


Methods :

This is a prospective single-centre series of consecutive patients undergoing ERBT regardless of tumour size. When ERBT was deemed unfeasible, the operating surgeon would be allowed to switch to conventional piecemeal resection. Peri-operative and histological outcomes were reviewed. Patients who failed ERBT were followed up to determine whether they could be successfully managed by piecemeal resection alone.


Results :

From May to October 2016, a total of 48 patients were included. ERBT was successful in 36 of them, and the remaining 12 patients were converted to conventional piecemeal resection. For the 12 patients who had piecemeal resection, 4 had muscle-invasive bladder cancer requiring cystectomy, 1 had T1 high-grade bladder cancer with carcinoma-in-situ requiring cystectomy and 3 had incomplete resection despite conventional piecemeal resection. Therefore, after excluding these 8 patients, ERBT only failed in 4 out of 40 patients who were definitively managed by piecemeal resection, resulting in a successful ERBT rate of 90%. In the 36 patients who had success EBRT, 64 non-muscle-invasive bladder cancers were resected. Clear resection margins were achieved in 98.4% of the patients. Presence of detrusor muscle was also achieved in 98.4% of the patients. Two patients had re-admission for haematuria which resolved upon conservative management. None of our patients experienced bladder perforation after ERBT.


Conclusions :

ERBT is safe and technically feasible for most patients with bladder tumours. Clear resection margins and presence of detrusor muscle were readily achieved in ERBT specimens.

Jeremy Yuen-Chun Teoh

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Hong Kong

Chi-Fai Ng

Director and Professor
S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Not Applicable, Hong Kong

Dr NG Chi Fai, Anthony graduated in the Chinese university of Hong Kong in 1993. He then joined Department of Surgery, Prince of Wales Hospital, as surgical trainee. After his basic training, he decided to become an urologist and became a specialist in 2001. Attracted by the rapid development in endourology, he spent one year in Scotland, worked under Mr David Tolley, and gained extensive experience in endo-laparoscopic surgery and stone management.

After completion of his training, Dr Ng decided to join the Chinese University of Hong Kong in 2006 and is currently Director and Professor of the S.H. Ho Urology Centre, Department of Surgery, the Chinese University of Hong Kong. He is also the Course Director of the Robotic Surgery Training Programme, CUHK Hong Kong Jockey Club Minimally Invasive Surgical Skill Centre. He has a wide range of interest, in particular in prostate diseases, urolithiasis, and promotion of men’s health. He was also honored with the Outstanding Young Urologist Award in 2010 by the Asian Congress of Urology, the International Guest Scholar 2012 of the American College of Surgeons, the World Chinese Urology Association Award 2014 and the Outstanding Contribution Award 2017 of the International Alliance of Urolithiasis, as recognitions to his work in the field.

Billy Kai-Ming Lai

Resident
S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Not Applicable, Hong Kong

I am a resident who previously worked under the Urology team of the Chinese University of Hong Kong.

Eddie Shu-Yin Chan

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Not Applicable, Hong Kong

Joseph Kai-Man Li

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Not Applicable, Hong Kong

Chi-Hang Yee

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Not Applicable, Hong Kong

Peter Ka-Fung Chiu

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Not Applicable, Hong Kong

Joseph Hon-Ming Wong

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Hong Kong

Simon See-Ming Hou

S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Hong Kong, Not Applicable, Hong Kong