[Percutaneous transabdominal whole layer core needle biopsy for staging the urinary bladder cancer]

Accurate staging is one of the most important determinants necessary in planning an effective treatment for bladder cancer, but at the present time, staging by the conventional clinical methods are not completely reliable. Accordingly, we have newly developed a percutaneous transabdominal core needle biopsy technique capable of obtaining good cylindrical specimens of the entire layer. In order to obtain the core specimen of the bladder wall, which is a vesico-elastic material, the biopsy needle must penetrate the bladder wall at an extremely high speed. We have developed an original automatic biopsy instrument and modified the head of needle for this purpose. With this method, we could obtain good core specimens for pathological staging in about 90% cases. The correlation between the pathological stagings of core specimens and those of cystectomy specimens were in good agreement. This technique is accurate not only for preoperative pathological staging, but also monitoring histopathologically the responsiveness of multi-disciplinary treatment for invasive bladder cancer. This method allows us to determine the optimal therapeutic modality for managing individual patient with invasive bladder cancer.