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Randomized Study of Short-time Continuous Saline Irrigation After Transurethral Resection in Non-muscle Invasive

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Short-time continuous saline bladder irrigation (S-CSBI) is as effective as long-time CSBI (L-CSBI) for preventing bladder tumor recurrence after TURBT. This finding supports S-CSBI as a viable option for non-muscle invasive bladder cancer patients.

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Area of Science:

  • Urology
  • Oncology
  • Surgical Innovation

Background:

  • Transurethral resection of bladder tumor (TURBT) is a standard procedure for non-muscle invasive bladder cancer (NMIBC).
  • Continuous saline bladder irrigation (CSBI) is often used post-TURBT to prevent complications.
  • The optimal duration of CSBI (short-time vs. long-time) requires investigation.

Purpose of the Study:

  • To compare the efficacy and safety of short-time continuous saline bladder irrigation (S-CSBI) versus long-time CSBI (L-CSBI) after TURBT in NMIBC patients.
  • To assess the non-inferiority of S-CSBI to L-CSBI based on 2-year recurrence-free survival (RFS).

Main Methods:

  • A randomized trial involving 323 patients with suspected primary NMIBC between 2016-2021.
  • Patients received either 3-hour S-CSBI or overnight L-CSBI post-TURBT.
  • Exclusion criteria included highest-risk NMIBC and muscle-invasive bladder cancer.

Main Results:

  • The 2-year recurrence-free survival (RFS) rates were 70.5% for both S-CSBI and L-CSBI groups.
  • S-CSBI was confirmed as non-inferior to L-CSBI, meeting the predefined non-inferiority margin.
  • No severe systemic toxicities were noted; hematuria grade IIIa was slightly higher in the S-CSBI group but not statistically significant.

Conclusions:

  • Short-time continuous saline bladder irrigation (S-CSBI) is non-inferior to long-time CSBI (L-CSBI) for 2-year recurrence-free survival after TURBT in NMIBC.
  • S-CSBI offers a practical and potentially advantageous alternative, particularly for day surgery settings.
  • S-CSBI represents a viable treatment option for patients undergoing TURBT for NMIBC.