Urology Annals

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 12  |  Issue : 4  |  Page : 341--346

Role of surgeon experience in the outcome of transurethral resection of bladder tumors


Mohamed Hassan Ali, Ahmed Eltobgy, Iman Yehia Ismail, Ammar Ghobish 
 Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Correspondence Address:
Dr. Mohamed Hassan Ali
Department of Urology, Faculty of Medicine, Suez Canal University, Round Road, Ismailia
Egypt

Purpose: The purpose of the study is to assess the quality of transurethral resection of bladder tumors (TURBTs) performed by “senior” and “junior” urologists in terms of detrusor muscle (DM) presence at the initial resection and presence of missed and residual tumors at second-look TURBT. Patients and Methods: An analytic prospective cohort study included 171 patients with stage T1 and Ta bladder cancer who had undergone an initial TURBT. Patients were divided into two groups according to surgeon experience. Group 1 (116 patients) operated on by senior surgeons (consultants and trainees in year 5 or 6) and Group 2 (55 patients) operated on by junior surgeons (trainees below year 5). All patients underwent second-look TURBT (by a senior urologist) within 2–6 weeks after the initial resection. The outcome of the initial and re-TURBT represented with regard to the surgeon experience. Results: There is a statistically significant difference between senior and junior surgeons regarding the presence or absence of DM in the initial resection (P = 0.001). A significant relation between the presence of residual tumors in re thermodynamic uncertainty relation (TUR) in relation to the initial operator was found (P = 0.03). Re-TURBT of patients in Group 1 (initially operated on by experienced surgeons) revealed that 57.7% had tumor-free resection while 36.2% had residual tumors, 5.2% had missed lesion and only 0.9% had concurrent residual and missed tumors. In contrast, from Group 2 (55 patients operated by junior surgeons) 47.3% had residual tumor, 21.8% had missed lesions, and 9.1% had concurrent residual and missed tumors in re-TUR. Conclusions: Nonmuscle invasive bladder cancer treated with TURBT should be managed as any other major oncologic procedure. TURBT should be performed by an experienced surgeon or with very close supervision when done by training urologist.


How to cite this article:
Ali MH, Eltobgy A, Ismail IY, Ghobish A. Role of surgeon experience in the outcome of transurethral resection of bladder tumors.Urol Ann 2020;12:341-346


How to cite this URL:
Ali MH, Eltobgy A, Ismail IY, Ghobish A. Role of surgeon experience in the outcome of transurethral resection of bladder tumors. Urol Ann [serial online] 2020 [cited 2020 Dec 1 ];12:341-346
Available from: https://www.urologyannals.com/article.asp?issn=0974-7796;year=2020;volume=12;issue=4;spage=341;epage=346;aulast=Ali;type=0