Retur, tekrarlanan tur, ikinci bakış, ikinci tur, tekrar tur. Yapılmalı mı, ne zaman yapılmalı, nasıl yapmalı?

  • Ali F. Şahin
  • Rauf Taner Divrik

Bull Urooncol 2010;9(1):30-34

Transurethral resection of the bladder tumours is the mainstay approach in the diagnosis and the treatment of bladder cancer. The first and the most important rule is the complete resection of the superficial bladder cancer. This procedure is not only mandatory for adequate staging but also serves as the completion of TURB for most of the superficial tumours. Because of the complexities of definitions, both the rate of the residual tumour and under staging after the second TUR was reported in a wide range. The TUR after incomplete resection has to be called repeat resection. If second intervention was done to provide additional pathologic information for the muscularis propria, it has to be called restaging TUR. Second TUR has to be used only if the procedure was done after complete and correct TUR. The significant risk of residual tumour after the initial TUR has been demonstrated in many studies. The tumour may be under staged by the initial resection. Second TUR should be performed when a high-grade, non-muscle invasive tumour or a T1 tumour has been detected at the initial TUR. Second TUR reduces recurrence and progression and improves the initial response rate to BCG instillation therapy. Most authors recommend resection at 2-6 weeks after the initial TUR. The procedure should include a resection of the primary tumour site.