Transurethral resection of bladder tumor - Revision history

Chris.Rishel: Added information about obturator jerk reflex

2024-04-09T15:22:05Z

Added information about obturator jerk reflex

@@ Line 5: / Line 5: @@
 | monitors = Standard
 | considerations_preoperative =
-| considerations_intraoperative =
+| considerations_intraoperative = Muscle relaxation may be requested by surgeon
 | considerations_postoperative =
 }}
-A transurethral resection of bladder tumor (TURBT) is an endoscopic procedure used to diagnose, stage, and treat early tumors of the bladder.  A resectoscope is passed into the bladder via the urethra and used to remove visible tumor.
+A '''transurethral resection of bladder tumor''' ('''TURBT''') is an endoscopic procedure used to diagnose, stage, and treat early tumors of the bladder.  A resectoscope is passed into the bladder via the urethra and used to remove visible tumor.
 == Preoperative management ==
@@ Line 51: / Line 51: @@
 === Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
 == Intraoperative management ==
 === Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===
 === Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
 === Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
@@ Line 64: / Line 72: @@
 === Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===
-* Stimulation of the obturator nerve during resectoscope passage into the urethra can cause a significant reflect, even while under GA.  To avoid this reflex, muscle relaxation is often used.  However, studies<ref>{{Cite journal|date=2007-08-01|title=Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor|url=https://www.sciencedirect.com/science/article/abs/pii/S1000194807600471|journal=Journal of Medical Colleges of PLA|language=en|volume=22|issue=4|pages=234–237|doi=10.1016/S1000-1948(07)60047-1|issn=1000-1948}}</ref> have shown that TIVA with LMA is a safe, reliable, and controllable method for maintenance of anesthesia with blunting of the obturator reflex.
+* Stimulation of the obturator nerve can cause significant movement, which creates risk of bladder perforation
 === Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
@@ Line 82: / Line 93: @@
 * Bleeding
 * Reabsorption
 == References ==

Chris.Rishel: Text replacement - "|Respiratory" to "|Pulmonary"

2022-02-22T05:44:43Z

Text replacement - "|Respiratory" to "|Pulmonary"

← Older revision		Revision as of 22:44, 21 February 2022
Line 25:		Line 25:
	\|		\|
	\|-		\|-
	\|~~Respiratory~~		\|Pulmonary
	\|		\|
	\|-		\|-

Tony.Wang at 01:44, 24 May 2021

2021-05-24T01:44:03Z

← Older revision		Revision as of 18:44, 23 May 2021
Line 124:		Line 124:
	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
	<references />		<references />
	[[Category:~~Urologic surgery~~]]		[[Category:Urology]]

Barrett.Larson at 18:38, 16 April 2021

2021-04-16T18:38:06Z

← Older revision		Revision as of 11:38, 16 April 2021
Line 123:		Line 123:

	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
			<references />
			[[Category:Urologic surgery]]

Barrett.Larson: Created page with "{{Infobox surgical case reference | anesthesia_type = GA or Neuraxial | airway = ETT/LMA (if GA) | lines_access = PIV x 1 | monitors = Standard | considerations_preoperative =..."

2021-04-16T18:10:00Z

Created page with "{{Infobox surgical case reference | anesthesia_type = GA or Neuraxial | airway = ETT/LMA (if GA) | lines_access = PIV x 1 | monitors = Standard | considerations_preoperative =..."

New page

{{Infobox surgical case reference
| anesthesia_type = GA or Neuraxial
| airway = ETT/LMA (if GA)
| lines_access = PIV x 1
| monitors = Standard
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

A transurethral resection of bladder tumor (TURBT) is an endoscopic procedure used to diagnose, stage, and treat early tumors of the bladder. A resectoscope is passed into the bladder via the urethra and used to remove visible tumor.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Respiratory
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

* Lithotomy

=== Maintenance and surgical considerations ===

* Stimulation of the obturator nerve during resectoscope passage into the urethra can cause a significant reflect, even while under GA. To avoid this reflex, muscle relaxation is often used. However, studies<ref>{{Cite journal|date=2007-08-01|title=Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor|url=https://www.sciencedirect.com/science/article/abs/pii/S1000194807600471|journal=Journal of Medical Colleges of PLA|language=en|volume=22|issue=4|pages=234–237|doi=10.1016/S1000-1948(07)60047-1|issn=1000-1948}}</ref> have shown that TIVA with LMA is a safe, reliable, and controllable method for maintenance of anesthesia with blunting of the obturator reflex.

=== Emergence ===

== Postoperative management ==

=== Disposition ===

* PACU

=== Pain management ===

=== Potential complications ===

* Bladder perforation (most serious complication)
* Urethral rupture or false passage
* Bleeding
* Reabsorption

== Procedure variants ==

{| class="wikitable"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]