In departments with urological training of residents, part of the TURB procedures are performed as "teaching surgery".
Does resection quality and early recurrence depend on the operator's experience? From July 2007 to February 2012 254 second resections (TURB) after Ta high-grade and T1 high-grade bladder tumours were performed at our institution. The surgeons were stratified into "junior residents" (first and second year of training), "experienced residents" (3rd-5th year of training), board certified urologists, consultants and chief surgeons. We analysed the risk of recurrence at second resection and characteristics of the initial TURB.87 patients presented with a Ta high-grade tumour (34.3%) and 167 had a T1 high-grade lesion (67.7%). Most TURBs were performed by "experienced residents" (3rd-5th year) and the chief of department. The recurrence rate at second resection was 52.4%. A significant association with the recurrence rate was shown for the number of initial tumours, size and T-stage. No association was found for the training level of the surgeon. Additionally, there was no different detrusor rate for the surgeons, as a parameter for a correct, muscle-deep TURB. A bias that surgeons in training had more favourable tumours (solitary, less than 3 cm) could be excluded.In our data detrusor rate and recurrence risk at second resection are independent of the surgeon's experience. The results of "teaching-TURBs" are not inferior compared to TURBs performed by board certified urologists or consultants under the conditions of undisturbed communication and personal supervision.
Written by:
Lazica DA, Degener S, Böttcher S, Brandt AS, Störkel S, Roth S. Are you the author?
Klinik für Urologie und Kinderurologie, HELIOS Klinikum Wuppertal, Zentrum für Forschung in der klinischen Medizin (ZFKM), Universität Witten/ Herdecke.
Reference: Aktuelle Urol. 2013 May;44(3):196-200.
doi: 10.1055/s-0033-1345144
PubMed Abstract
PMID: 23712276
Article in German.
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