Study population and protocol
With the permission of the local ethics committee, the patients to whom
re-TUR operation was performed between 2013-2020 in our clinic were
retrospectively included to the study. Patients underwent TUR-B
operation under general or spinal anaesthesia by the continuous flow 27
French 30 ° optic resectoscope instrument and video camera system (Karl
StorzTM, Tuttlingen, Germany).
The patients who were at intermediate and high-risk classification were
included to the study. The patients with Ta_Low grade pathology that
present one of these parameters; multiple, recurrent or >3
cm tumors were considered as intermediate risk NMIBC. Therefore re-TUR
was also applied for these Ta_Low grade patients who were classified in
the intermediate risk group. On the other hand, the patients who had
low-risk NMIBC, patients with MIBC, patients with in-complete TUR-B and
the patients who had no muscle tissue in the pathologic specimen, were
excluded from the study.
The re-TUR operation was performed approximately 4-6 weeks after the
index TUR-B for intermediate and high-risk NMIBC patients. During re-TUR
operation, resection was performed from the same area of the primary
tumor including the deep muscle layer, regardless of the residual or
recurrent tumour. The re-TUR specimen was checked for any residual tumor
and whether there was a change in tumour stage or grade. All the
patients who were not upstaged to MIBC received standard BCG
immunotherapy.
Both TUR-B and re-TUR pathology characteristics including tumor stage,
tumor grade, tumor size, tumor number, presence of lymphovascular
invasion (LVI), presence of CIS, presence of variant pathology and the
tumor risk status were analysed. The Re-TUR positivity (residual tumor)
of the patients were evaluated and analysed according to these
variables.