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The investigators compare the recurrence rate difference between two years after transurethral resection of the bladder tumor according to the method of anesthesia. Anesthetic methods are general anesthesia and spinal anesthesia. Assessment of recurrence is assessed by bladder endoscopy, CT, and pathological examination of surgical specimens.
Research Background Most of the bladder cancer (approximately 85%) has histologic features of urothelial carcinoma. Approximately 75% of the patients initially diagnosed as non-invasive bladder cancer (stage I, CIS) or submucosal stage T1 -muscle invasive bladder cancer - NMIBC). However, it has been reported that about 60% to 70% of patients experience recurrence and 20% to 30% of relapsed cancers require radical cystectomy or chemotherapy It is known to progress to high-grade or high grade cancer.
There are studies that involve surgical factors such as volatile anesthetics, narcotic analgesics, anti-body temperature, blood transfusion, and cancer recurrence. Minimizing the use of volatile anesthetics and narcotic analgesics reduces spinal anesthesia before and after surgery, It has been reported that there is a correlation with maintenance of immune cell function
Research hypothesis and purpose The aim of this study was to evaluate the recurrence rate, recurrence - free survival rate, and recurrence - free survival rate of non - muscle invasive bladder carcinoma in patients undergoing bladder resection.
Research Method
Urine analysis, urine culture, urine cytology, and cystoscopy were performed every 3 months up to 2 years postoperatively. CT urography performed once a year
Follow-up procedure: Follow-up procedure according to bladder cancer standard.
4. Observation items, clinical examination items and observational examination methods
Screening: CT urography, Urine analysis, Urine culture, Urine cytology, Cystoscopy. Observe
Follow up: Urine analysis, Urine culture, Urine cytology, Cystoscopy every 3 months after the operation, CT urography every year
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| General anesthesia | Experimental | Group of general anesthesia before transurethral resection of the bladder tumor anesthesia: propopol |
|
| Spinal anesthesia | Experimental | Group of spinal anesthesia before transurethral resection of the bladder tumor anesthesia: bupibacaine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Anesthesia before transurethral resection of the bladder tumor | Procedure | General anaesthesia or general anesthesia (see spelling differences) is a medically induced coma with loss of protective reflexes, resulting from the administration of one or more general anaesthetic agents. Spinal anaesthesia is a form of regional anaesthesia involving the injection of a local anaesthetic into the subarachnoid space, generally through a fine needle |
| Measure | Description | Time Frame |
|---|---|---|
| 2-year recurrence-free survival rate | The criteria for recurrence-free survival and recurrence of bladder cancer for 2 years postoperatively are based on pathological histology. If the recurrence is suspected in the radiological examination but pathological histological examination is difficult, the reference is based on the day of the imaging examination suspected of recurrence. | Follow up every 3 months until 2 years after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| 2-year progression-free survival | The progression-free survival rate and progression rate of bladder cancer for 2 years postoperatively include both T stage and tumor grade progression. | Follow up every 3 months until 2 years after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hyeong Dong Yuk, MD | Contact | +82-2-2072-1968 | hinayuk@naver.com | |
| Song Hee Kim, Bacheolo | Contact | +82-2-2072-1968 | songheekim0506@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Jin Tae Kim, PhD | Professor, Department of Anesthesiology, Seoul National University Hospital | Study Director |
| Ja Hyeon Ku, PhD | Professor, Department of Urology, Seoul National University Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 110-744 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15199091 | Result | Herr HW, Faulkner JR, Grossman HB, Natale RB, deVere White R, Sarosdy MF, Crawford ED. Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol. 2004 Jul 15;22(14):2781-9. doi: 10.1200/JCO.2004.11.024. Epub 2004 Jun 15. | |
| 24390799 | Result | Christodouleas JP, Baumann BC, He J, Hwang WT, Tucker KN, Bekelman JE, Tangen CM, Lerner SP, Guzzo TJ, Malkowicz SB, Herr H. Optimizing bladder cancer locoregional failure risk stratification after radical cystectomy using SWOG 8710. Cancer. 2014 Apr 15;120(8):1272-80. doi: 10.1002/cncr.28544. Epub 2014 Jan 3. |
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After randomization, they were divided into two parallel groups 289 patients were randomly assigned to a spinal anesthesia group and a general anesthesia group 1: 1.
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Using a web site, and creating a randomized list at Sealedenvalop.com. Patients are randomly assigned to receive an anesthetic consent, and no masking is performed.
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|
| Anesthesia | Drug | General anaesthesia : propopol Spinal anaesthesia : bupibacaine |
|
| Hyeong Dong Yuk, MD | Clinical fellow, Department of Urology, Seoul National University Hospital | Principal Investigator |
| Song Hee Kim, Bacheolor | Researcher, Department of Urology, Seoul National University Hospital | Principal Investigator |
| Jae Hyun Jung, MD | Clinical fellow, Department of Urology, Seoul National University Hospital | Principal Investigator |
| Jung Hoon Lee, MD | Clinical fellow, Department of Urology, Seoul National University Hospital | Principal Investigator |
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| 29733090 | Result | Kweon TD, Lee KY. Spinal anesthesia is associated with lower recurrence rates after resection of non-muscle invasive bladder cancer. Transl Androl Urol. 2018 Apr;7(2):283-286. doi: 10.21037/tau.2018.03.13. No abstract available. |
| 39740955 | Derived | Han JH, Yuk HD, Jeong SH, Jeong CW, Kwak C, Kim JT, Ku JH. Anesthetic approaches and 2-year recurrence rates in non-muscle invasive bladder cancer: a randomized clinical trial. Reg Anesth Pain Med. 2026 Apr 2;51(4):379-384. doi: 10.1136/rapm-2024-105949. |
| ID | Term |
|---|---|
| D001749 | Urinary Bladder Neoplasms |
| ID | Term |
|---|---|
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| D000758 | Anesthesia |
| ID | Term |
|---|---|
| D000760 | Anesthesia and Analgesia |
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