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      Innovative technique in nonmuscle invasive bladder cancer-bipolar plasma vaporization.


      Adult, Aged, Aged, 80 and over, Endoscopy, methods, Female, Humans, Length of Stay, Male, Middle Aged, Neoplasm Recurrence, Local, epidemiology, Prospective Studies, Urinary Bladder Neoplasms, surgery, Urologic Surgical Procedures, Volatilization

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          To evaluate the efficacy and safety of a newly introduced endoscopic technique in the treatment of nonmuscle-invasive bladder tumors (NMIBT), the bipolar plasma vaporization of bladder tumors (BPV-BT), and to compare it with monopolar transurethral resection of bladder tumors (TURBT). A total of 120 patients with at least one bladder tumor larger than 3 cm were enrolled in the study and randomized for BPV-BT and TURBT. Resection biopsy followed by tumor plasma vaporization and biopsies of the tumoral bed were performed in the 60 cases of the BPV-BT arm. All NMIBT patients underwent monopolar Re-TURBT 4 weeks after the initial procedure. The mean operative time and postoperative hemoglobin decrease were significantly improved for BPV-BT compared with TURBT (21.4 minutes vs 32.7 minutes and 0.3 g/dL vs 0.9 g/dL). The perioperative complications were more frequent in the TURBT arm. The mean catheterization period and hospital stay were significantly shorter in the BPV-BT series (2.5 vs 3.5 days and 3.5 vs 4.5 days). During follow-up, the overall residual tumors' rate at Re-TURBT was 9.3% in the BPVBT group vs 20.8% in the TURBT group. Primary site recurrences occurred in 7.4% vs 17% of the cases, whereas in patients with initial multiple tumors, the recurrence rate was 9.7% vs 25%. BPV-BT seems to represent a promising endoscopic treatment alternative for NMIBT patients, with good efficacy, reduced morbidity, fast postoperative recovery, and significantly decreased residual tumors' rate by compared with TURBT. Copyright © 2011 Elsevier Inc. All rights reserved.

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