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Comparing the short - term outcomes and complications of monopolar and bipolar transurethral resection of bladder tumors in patients with coronary artery disease: a prospective, randomized, controlled study.

Journal article
Authors Deniz Bolat
Bulent Gunlusoy
Özgu Aydogdu
Mehmet Erhan Aydin
Cetin Dincel
Published in International braz j urol : official journal of the Brazilian Society of Urology
Volume 44
Issue 4
Pages 717-725
ISSN 1677-6119
Publication year 2018
Published at
Pages 717-725
Language en
Links dx.doi.org/10.1590/S1677-5538.IBJU....
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Aged, Aged, 80 and over, Coronary Artery Disease, complications, physiopathology, Female, Humans, Male, Middle Aged, Operative Time, Postoperative Complications, Prognosis, Prospective Studies, Risk Factors, Treatment Outcome, Ureteroscopy, adverse effects, methods, Urinary Bladder Neoplasms, pathology, surgery
Subject categories Clinical Medicine

Abstract

To compare the perioperative outcomes and complications of monopolar and bipolar transurethral resection of bladder tumors (TURBT) in patients with coronary artery disease (CAD).A total of 90 CAD patients with newly diagnosed bladder cancer who underwent TURBT were randomized into monopolar TURBT (M-TURBT) and bipolar TURBT (B-TURBT) groups. Primary outcome was safety of the procedures including obturator jerk, bladder perforation, clot retention, febrile urinary tract infection and TUR syndrome. The secondary outcome was the efficacy of TURBT procedures, including complete tumor resection, sampling of the deep muscle tissue and sampling of the qualified tissues without any thermal damage.Mean ages of the patients in M-TURBT and B-TURBT groups were 71.36±7.49 and 73.71±8.15 years, respectively (p=0.157). No significant differences were found between M-TURBT and B-TURBT groups regarding complete tumor resection (76.2% vs. 87.5%, p=0.162) and muscle tissue sampling rates (71.4% vs. 64.6%,p=0.252). Obturator jerk was detected in 16.7% of the patients in M-TURBT group and 2.1% in B-TURBT group (p=0.007). No statistically significant differences were found between the groups regarding intraoperative and postoperative complications.Both monopolar and bipolar systems can be used safely and effectively during TURBT procedure in CAD patients. Due to the more frequently seen obturator jerk in M-TURBT than B-TURBT, careful surgical approach is needed during M-TURBT.

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