Transcript An audit comparing the quality of TURBT in a dedicated and non

An audit comparing the quality of TURBT in a
dedicated and non-dedicated TURBT list
Yeo, L and Jain, S
Yeo, L and Jain, S
 Textbook TUR:
Resection of: exophytic part, tumour base, edges
 Dedicated TURBT list from Nov 2010
 Methods:
 101 patients with new diagnosis of bladder cancer
 51 operated on dedicated list; 50 on general list
 Quality of TUR: a) muscle on initial TUR, b) rate of
residual tumour (T1), c) recurrence at first check (Ta)
Results
Outcome
Muscle present
Re-resection outcome (T1):
Residual tumour
Upstaging
General
Dedicated
(n=50)
(n=51)
33 (66%)
45 (88%)
5/11 (45%)
1/5 (20%)
4/24 (17%)
3/13 (23%)
0/3
5/12 (42%)
No data for 3
No data for 8
Recurrence at 1st check (Ta)
Conclusion
 Mariappan et al. Eur Urol 2010:57:843-849
 Detrusor muscle seen 67.7%
 Absence of detrusor muscle associated with both  residual
disease & recurrence
 Dedicated TURBT list:
 88% detrusor muscle
 Philosophy: complete TUR
muscle sampling and therefore  rates of residual tumour
 Intra-op MMC
 Valuable training opportunity


Thank you
Any questions?
Rate of muscle sampling
Surgeon
General
Dedicated
Cons
68% (23/34)
90% (19/21)
SpR
63% (10/16)
87% (26/30)
Pre-selected cases for SpR at team brief
Consultant supervision
Complication rate
Surgeon
Cons
SpR
General
Dedicated
1
(AUR)
0
0
3
(Died of MI, AUR, returned
to theatre for bleeding)
These complications were seen in the muscle group