Histopathological Findings in En-Bloc vs Conventional Transurethral Resection of Bladder Tumors.

Ain Shams University50 enrolled

Overview

This study is designed to determine whether en-bloc TURBT provides superior histopathological quality and clinical outcomes compared to conventional TURBT in medium-sized bladder tumors.

This study is a prospective randomized clinical trial conducted at Ain Shams University to compare en-bloc transurethral resection (ERBT) with conventional transurethral resection (TURBT) for urinary bladder tumors sized 2-6 cm. The primary endpoint is the presence of detrusor muscle in histopathological specimens, while secondary outcomes include bladder perforation, residual disease at second TURBT, margin status, operation time, obturator reflex, and conversion rates. By focusing on specimen integrity and surgical efficacy, the study aims to determine whether en-bloc TURBT provides superior diagnostic accuracy and clinical outcomes compared to the conventional approach.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

SINGLE

Enrollment

Conditions

Urinary Bladder Cancer

Interventions

En bloc TURBT using a bipolar Karl-Storz resectoscope system fitted with a specialized "flat" resection loopPROCEDURE

A specialized "flat" resection loop (Karl-Storz En-Bloc Electrode, stainless steel, approximately 24 mm diameter). This loop features a broad, planar configuration with a smooth leading edge designed to dissect beneath the tumor base in a single piece while maintaining an intact specimen-muscle interface and minimizing fragmentation.

Bipolar piecemeal TURBT using the same bipolar Karl-Storz resectoscopic platformPROCEDURE

The resections were performed with a standard U-shaped cutting loop electrode (Karl-Storz, stainless steel, 24 mm diameter) mounted on a bipolar working element compatible with a 26-Fr continuous-flow resectoscope sheath and a 30-degree Hopkins® rod-lens telescope. The U-shaped loop, characterized by its semi elliptical contour and dual active cutting arms, facilitates sequential layer-by-layer resection of the tumor in multiple fragments, permitting simultaneous coagulation of bleeding vessels.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Tumor diameter of 2-6 cm * Patients fit for spinal or general anesthesia Exclusion Criteria: * recurrent bladder tumours. * concomitant urothelial cancer of the upper urinary tract * metastatic bladder cancer

Locations (1)

Ain Shams University

Cairo, Abbasia, Egypt

Outcomes

Primary Outcomes

the presence of detrusor muscle in histopathologic specimens

This assessment aims to compare the histopathological outcomes between the tumors obtained from the en bloc bipolar resection versus the conventional method bipolar Trans-Urethral Resection of Bladder Tumor techniques

Time frame: 10 days post TURBT

Data from ClinicalTrials.gov

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