En-bloc transurethral resection vs. conventional transurethral resection for primary non-muscle invasive bladder cancer: A meta-analysis

Introduction: We performed a meta-analysis to evaluate the effect of en-bloc transurethral resection vs. conventional transurethral resection for primary non-muscle invasive bladder cancer.Methods: A systematic literature search up to January 2022 was done and 28 studies included 3714 primary non-muscle invasive bladder cancer subjects at the start of the study; 1870 of them were en-bloc transurethral resection, and 1844 were conventional transurethral resec-tion for primary non-muscle invasive bladder cancer. We calculated the odds-ratio (OR) and mean-difference (MD) with 95% confidence-intervals (CIs) to evaluate the effect of en-bloc transurethral resection compared with conventional transurethral resection for primary non -muscle invasive bladder cancer by the dichotomous or continuous methods with random or fixed-effects models.Results: En-bloc transurethral resection had significantly lower twenty-four-month recurrence (OR: 0.63; 95%CI: 0.50-0.78; P < 0.001), catheterization-time (MD: -0.66; 95%CI: -1.02-[-0.29]; P < 0.001), length of hospital stay (MD: -0.95; 95%CI: -1.55-[--0.34]; P = 0.002), postoperative bladder irrigation duration (MD: -6.06; 95%CI: -9.45-[-2.67]; P < 0.001), obturator nerve reflex (OR: 0.08; 95%CI: 0.02-0.34; P = 0.03), and bladder perforation (OR: 0.14; 95%CI: 0.06-0.36: P < 0.001) and no significant difference in the 12-month-recurrence (OR: 0.79; 95%CI: 0.61-1.04; P = 0.09), the operation time (MD: 0.67; 95%CI: -1.92-3.25; P = 0.61), and urethral stricture (OR: 0.46; 95%CI: 0.14-1.47; P = 0.19) compared with conventional transurethral resection for primary non-muscle invasive bladder cancer subjects. Conclusions: En-bloc transurethral resection had a significantly lower twenty-four-month recurrence, catheterization time, length of hospital stay, postoperative bladder irrigation duration, obturator nerve reflex, bladder perforation, and no significant difference in the twelve-month recurrence, operation time, and urethral stricture compared with conventio-nal transurethral resection for primary non-muscle invasive bladder cancer subjects. Further studies are required.& COPY; 2022 Published by Elsevier Espana, S.L.U. on behalf of AEU.