Outpatient transurethral resection of bladder tumors: A systematic review of oncologic and safety outcomes
摘要
Non-muscle invasive bladder cancer has high recurrence rates and its frequent treatment can become a burden for both the patient and healthcare professionals. Recent treatment advances have focused on lessening the invasiveness of treatment options through laser ablation and outpatient resection. Several randomized controlled trials have highlighted the efficacy of laser ablation for small bladder tumor recurrences, however outpatient tumor resection techniques that allow for histopathological analysis remain unstudied.
MethodsWe conducted a systematic search on PubMed and Embase libraries, including all clinical studies conducted through March 2025. Outpatient studies were included if they mentioned TURBT or flexible cystodiathermy. The search adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias for nonrandomized studies was assessed using the Risk Of Bias In Non-randomised Studies–of Interventions (ROBINS-I) tool.
ResultsOur search identified 901 eligible records of which 18 were included in the final analysis. Same day-discharge success rate was high between 92 and 100%. Outpatient TURBT and cystodiathermy were well tolerated in a population of younger and less comorbid patients, with low rates of complications (less than 11%) and similar oncological outcomes (30 to 60% recurrence rate at 2 years) to inpatient care. Anesthesia techniques ranged from local only to general anesthesia across studies. Additionally, Outpatient procedure divided the cost by up to 4 folds compared to the inpatient setting.
ConclusionOur review supports that outpatient TURBT or cystodiathermy is safe in selected, low risk NMIBC patients. Currently ongoing randomized trials will provide higher quality evidence on patient selection and cost-benefit analyses.