Outpatient Transurethral Resections of Bladder Tumors: Insights from the Largest Cohort to Date.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-02-11 DOI:10.1159/000543979

Maxime Pattou, Adrien Ochoa, Annabelle Goujon, Jérôme Verine, François Meyer, Sonia Bebane, François Gaudez, Paul Meria, François Desgrandchamps, Pierre Mongiat-Artus, Alexandra Masson-Lecomte

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引用次数: 0

Abstract

Introduction: Outpatient transurethral resection of bladder tumors (TURBT) is not widespread, involving only 5% of patients. Our aim was to assess the feasibility of TURBT in an outpatient setting and to evaluate factors possibly associated with conversion to inpatient care.

Methods: All consecutive outpatient-TURBT performed between January 2016 and December 2022 in one academic center was retrospectively analyzed. Outpatient success was defined as the absence of conversion to conventional hospitalization as well as the absence of unscheduled care within 30 postoperative days. The quality of the resection was assessed by the presence of detrusor muscle in the surgical specimen.

Results: A total of 500 consecutive outpatient-TURBT were included in 376 patients. Outpatient-TURBT was performed for primary tumor diagnosis in 187 (37%) cases, second look in 66 (13%) cases and tumor relapse in 216 (43%) cases. Muscle was present in 86% of cases. Perioperative inpatient conversions occurred in 40 cases (8%). Once converted, patients stayed a median of 2 days IQR (1;3). Seventy-seven post-TURBT unscheduled care were observed (15%) with 40 emergency room visits (8%) and/or 22 rehospitalizations (4%), occurring on a median postoperative day 3 IQR (1; 4). Overall complication rate was 11% (51 cases of grade 1 and 2 complications [10%] and 6 cases of grade 3 complications [1%]). Multivariate predictors of outpatient-TURBT failure were specimen weight ≥1 g (OR = 4.35, 95% CI: 1.60-13.3, p = 0.007), surgery duration (OR = 1.03, 95% CI: 1.06-1.71), p = 0.002) and antiplatelet treatment (OR = 2.86, 95% CI: 0.864-9.17, p = 0.077).

Conclusion: Outpatient TURBT appears to be acceptable with an 8% conversion rate, as well as safe, with an 11% complication rate. Quality of the resection was not affected by the outpatient setting. Tumor weight ≥1 g, surgery duration and absence of antiplatelet treatment were significant multivariate predictors of outpatient surgery failure.

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门诊经尿道膀胱肿瘤切除术：迄今为止最大队列的见解。

目的：门诊经尿道膀胱肿瘤切除术（turt）并不普遍，仅占5%的患者。我们的目的是评估TURBT在门诊环境中的可行性，并评估可能与转换为住院治疗和计划外治疗相关的因素。对象和方法：回顾性分析2016年1月至2022年12月在某学术中心进行的所有连续门诊TURBT。门诊成功被定义为没有转换为常规住院（CH）以及术后30天内没有计划外护理。通过手术标本中逼尿肌的存在来评估切除的质量。结果：376例患者共纳入500例连续门诊TURBT。门诊turbt诊断原发性肿瘤187例（37%），复诊66例（13%），复发216例（43%）。86%的病例存在肌肉。围手术期住院转换40例（8%）。一旦转换，患者的平均IQR停留时间为2天[1；3]。观察到77例turt术后计划外护理（15%），其中40例急诊（8%）和/或22例再住院（4%）发生在术后第3天[1；4)。总并发症发生率为11%（1、2级并发症51例（10%），3级并发症6例（1%））。门诊TURBT失败的多因素预测因子为标本重量≥1g （OR=4.35, 95%CI: 1.60 - 13.3, p=0.007）、手术时间（OR=1.03, 95%CI: 1.06 - 1.71）和抗血小板治疗（OR=2.86, 95%CI: 0.864 - 9.17, p=0.077）。结论：门诊TURBT转换率为8%，安全，并发症发生率为11%，是可以接受的。切除的质量不受门诊环境的影响。肿瘤重量≥1g、手术时间和未接受抗血小板治疗是门诊手术失败的重要多因素预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.