title: The value of extended good quality transurethral resection of bladder tumour in the treatment of the newly diagnosed bladder cancer.
abstract: OBJECTIVE
  To report our experience for the initial management of patients with newly diagnosed bladder tumours using our team approach for each case and using an aggressive extended transurethral resection of bladder tumour (TURBT) in order to investigate the real need for a routine 'second-look' cystoscopy in the current era.
  
  
  METHODS
  The study included 50 consecutive patients admitted to the urology department, of our tertiary care centre, for management of newly diagnosed bladder cancer. Exclusion criteria included past history of bladder tumour, palpable mass on bimanual examination under anaesthesia, presence of residual tumour at the end of resection, and patients with tumours of the bladder dome as thorough resection is difficult to achieve in this area without an attendant risk. Patients that had pathologically confirmed carcinomain situwere also excluded. White-light cystoscopy was used in all of the cases. Extended TURBT was defined as resection of the whole tumour, resection of the tumour base and 1 cm of apparently normal bladder wall around the circumference of the tumour.
  
  
  RESULTS
  The median (range) age of the patients was 52 (39-60) years. After initial TURBT, 10 patients (20%) were identified as having muscle-invasive bladder cancer. Of the remaining 40 patients, three had low-grade Ta disease, and so second biopsies were not taken. The remaining 37 patients had T1, grade 2-3 disease and none of them had evident residual disease at the site of tumour resection.
  
  
  CONCLUSIONS
  Re-staging TURBT could be safely omitted for select groups of patients. An experienced surgeon and teamwork, together with an extended TURBT can accurately achieve complete tumour resection, with accurate tumour staging, on initial resection.
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Mohamed Adel
authors.initials: MA
authors.lastname: Atta
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Ahmed Fouad
authors.initials: AF
authors.lastname: Kotb
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sharafeldeen
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elabbady
authors.affiliation: Department of Urology, Alexandria University, Alexandria, Egypt.
authors.forename: Mohamed Mohie
authors.initials: MM
authors.lastname: Hashad
keywords: Bladder cancer; CIS, carcinoma in situ; MIBC, muscle-invasive bladder cancer; NMIBC, non-muscle-invasive bladder cancer; RC, radical cystectomy; T1G3; TURBT; TURBT, transurethral resection of bladder tumour