Background: To establish a new technique for en bloc resection of bladder carcinoma using a transurethral laparoscopic technique.
Methods: Nine patients with primary bladder tumors underwent Partial Cystectomy with Transurethral Laparoscopic Technique (PCTLT). A 22 Fr Peel-Away sheath was inserted into the urethra for endoscopy, fluid discharge, and tumor removal. A 20.8 Fr nephroscope was used for observation. The operating channel of the nephroscope was utilized for appliance placement and perfusion. PKSTM Plasma-CutTM was used for tumor excision and haemostasis. Ultra-thin scissors were used for tumor separation and cutting. A laparoscope-like technique was utilized to perform en bloc resection of the tumor and the entire muscle layer at the base, as well as the surrounding tissues within 0.5 cm of the tumors. Intraoperative hemorrhage, operation time, obturator nerve reflex and postoperative complications were observed, and pathological stage and postoperative follow-up were performed.
Results: This technique was successful in all patients. No patients experienced bladder perforation or required open surgery. Perioperative blood loss was minimal and obturator nerve reflex was not obvious. Pathological stage of the tumors was Ta or T1. Patients were followed for 4 to 8 months postoperatively with no recurrence at the resection site and other site.
Conclusions: Preliminary clinical results have demonstrated that PCTLT is a safe and effective treatment of Non-Muscle Invasive Bladder Cancer (NMIBC), which contributes to the pathological staging and clinical treatment of the bladder carcinoma, whereas middle- and long-term clinical efficacy remains to be elucidated.Author(s): Congxiang Han, Jinyu Li, Xiacong Lin, Li Zhao, Zhongying Yu, Wei Li, Weijie Xu