Shariat - Figure 15
Checklist during TURBT
FIG. 15: To deliver the adequate TURBT, many factors must be taken into account that will determine not only the prognosis but also the response to further therapy. A 10-point checklist (plus 3 options), to improve the quality of TURBT (listed in the Figure) was published recently by a multi-institutional group of US urologists.[20]
Prognostic factors of importance to describe are the number of tumors, a description of the size of the largest tumor, the characteristics of the tumor (whether sessile, nodular, papillary, or flat), a history of the patient (whether the tumor is recurrent or primary), a description whether carcinoma in situ (CIS, associated, focal, or extensive), and the clinical tumor stage (2010 American Joint Committee on Cancer).
Intraoperatively, a bimanual examination is necessary for each patient undergoing TURBT. An assessment of whether the tumor was completely resected and whether detrusor muscle was seen at the resection base, and also visual evaluation of the perforation status, are also of importance. Optionally, photographic documentation can be done, as well as a drawing or description of the tumor location and obtaining separate deep biopsies of the resection bed to ensure that there is no muscle invasion.
References
Anderson C, Weber R, Darshan P, et al. A 10-Item checklist improves reporting of critical procedural elements during transurethral resection of bladder tumor. J Urol. 2016; 196, 1014−20 http://dx.doi.org/10.1016/j.juro.2016.03.151
