Use of surgical checklist during transurethral resection increases detrusor muscle collection rate and improves recurrence-free survival in patients with non-muscle-invasive bladder cancer

被引：17

作者：

Taoka, Rikiya ^{[1
]}

Tsunemori, Hiroyuki ^{[1
]}

Matsuoka, Yuki ^{[1
]}

Kohashiguchi, Kana ^{[1
]}

Miura, Takayoshi ^{[1
]}

Tohi, Yoichiro ^{[1
]}

Miyauchi, Yasuyuki ^{[1
]}

Kato, Takuma ^{[1
]}

Ueda, Nobufumi ^{[1
]}

Sugimoto, Mikio ^{[1
]}

机构：

[1] Kagawa Univ, Fac Med, Dept Urol, 1750-1 Ikenobe, Miki, Kagawa 7610793, Japan

来源：

INTERNATIONAL JOURNAL OF UROLOGY | 2021年 / 28卷 / 07期

关键词：

bladder cancer; non‐ muscle‐ invasive bladder cancer; recurrence‐ free survival; surgical checklist; transurethral resection of bladder tumor; EN-BLOC RESECTION; CARCINOMA; TUMOR; RISK; TA; PROGRESSION; DIAGNOSIS; IMPACT; 1ST;

D O I：

10.1111/iju.14548

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To elucidate the therapeutic benefits of using a surgical checklist during transurethral resection for non-muscle-invasive bladder cancer. Methods A nine-item surgical checklist was established in January 2016 to assess disease risk and resection adequacy, and it was prospectively implemented into clinical practice. Patients diagnosed with non-muscle-invasive bladder cancer who underwent complete resection from January 2009 to August 2019 were included in this study. The presence of detrusor muscle in the transurethral resection specimen and the intravesical recurrence-free survival were compared between patients who underwent transurethral resection before and after surgical checklist implementation. Results A total of 125 patients who underwent transurethral resection after surgical checklist implementation were reviewed and compared with 125 patients who underwent transurethral resection before surgical checklist implementation. The use of the surgical checklist led to an increase in the proportion of transurethral resection specimens containing detrusor muscle (92% vs 69.6%, P < 0.01) and a decrease in the recurrence rate (19.2% vs 49.6%, P < 0.01). Multivariate analysis showed that transurethral resection without a surgical checklist was an independent predictive factor influencing the absence of detrusor muscle in the transurethral resection specimen (odds ratio 4.78, P < 0.01) and intravesical recurrence (hazard ratio 1.92, 95% confidence interval 1.14-3.23; P = 0.01). Kaplan-Meier plots showed that the recurrence-free survival rate was significantly lower when the surgical checklist was not used (log-rank test result P < 0.01). Conclusions This study shows the therapeutic benefits of surgical checklist in improving the quality of resection during transurethral resection and reducing the recurrence rate in patients with non-muscle-invasive bladder cancer.

引用

页码：727 / 732

页数：6

共 21 条

[11] Final Results of an EORTC-GU Cancers Group Randomized Study of Maintenance Bacillus Calmette-Guerin in Intermediate- and High-risk Ta, T1 Papillary Carcinoma of the Urinary Bladder: One-third Dose Versus Full Dose and 1 Year Versus 3 Years of Maintenance [J].