膀胱肿瘤整块切除术（ERBT）已被引入以提高膀胱癌的切除质量。本综述旨在比较 ERBT 与传统经尿道膀胱肿瘤切除术 (cTURBT) 的围手术期和肿瘤学结果。使用 PubMed/Medline、Embase 和 Web of Science 数据库进行文献检索，以确定截至 2024 年 5 月发表的随机对照试验主要结局是复发和进展的风险。次要结果是逼尿肌 (DM) 存在、粘膜肌层 (MM) 可检测性、膀胱穿孔和闭孔神经反射率、手术时间、导尿和住院时间以及重复经尿道膀胱肿瘤切除术 (reTURBT) 时的残留肿瘤。 17研究符合我们的纳入标准。 12 个月复发（风险比 [RR] 0.81，95% 置信区间 [CI]：0.65-1.02；p = 0.08）和 24 个月复发（RR 1.02，95% CI：0.85-）没有观察到统计学显着差异。 1.22；p = 0.8）和 12 个月进展率（RR 0.68，95% CI：0.05-10.14；p = 0.8）。 ERBT 与较高的 DM 存在显着相关（RR 1.10，95% CI：1.01-1.20；p = 0.02），而 reTURBT 时的残留肿瘤和 MM 可检测性没有出现统计学上的显着差异（所有 p > 0.05）。 ERBT 与较低的膀胱穿孔风险 (p = 0.002) 和闭孔神经反射 (p < 0.001) 显着相关。最后，ERBT 与较长的手术时间、较短的导管插入时间和较短的住院时间显着相关。主要限制是纳入研究之间的异质性。ERBT 由于术中事件较少而更安全，但与 cTURBT 相比，肿瘤学结果没有显着差异。 ERBT 更高的 DM 检测可增强初始疾病分层，有可能改善临床决策和护理服务。与传统切除技术相比，膀胱肿瘤整块切除术术中并发症较低，且组织病理学信息优于传统切除技术。然而，肿瘤学结果没有差异强调了肿瘤特征、外科医生专业知识和术后护理等因素对后续事件的影响。版权所有 © 2024 欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。

En bloc resection of bladder tumor (ERBT) has been introduced to enhance the quality of resection of bladder cancer. This review aims to compare the perioperative and oncological outcomes of ERBT and conventional transurethral resection of bladder tumor (cTURBT).A literature search was conducted using the PubMed/Medline, Embase, and Web of Science databases to identify randomized controlled trials published until May 2024. The primary outcomes were the risk of recurrence and progression. The secondary outcomes were detrusor muscle (DM) presence, muscularis mucosae (MM) detectability, bladder perforation and obturator nerve reflex rates, operative time, length of catheterization and hospitalization, and residual tumor at repeat transurethral resection of bladder tumor (reTURBT).Seventeen studies met our inclusion criteria. No statistically significant difference was observed in 12-mo recurrence (risk ratio [RR] 0.81, 95% confidence interval [CI]: 0.65-1.02; p = 0.08), 24-mo recurrence (RR 1.02, 95% CI: 0.85-1.22; p = 0.8), and 12-mo progression (RR 0.68, 95% CI: 0.05-10.14; p = 0.8) rates. ERBT was significantly associated with a higher DM presence (RR 1.10, 95% CI: 1.01-1.20; p = 0.02), while no statistically significant difference emerged in the residual tumor at reTURBT and MM detectability (all p > 0.05). ERBT was significantly associated with a lower risk of bladder perforation (p = 0.002) and obturator nerve reflex (p < 0.001). Finally, ERBT was significantly associated with longer operative time, lower catheterization time, and lower length of hospital stay. The main limitation was heterogeneity among the included studies.ERBT is safer due to fewer intraoperative events, but there was no significant difference in oncological outcomes compared with cTURBT. Higher DM detection with ERBT enhances initial disease stratification, potentially improving clinical decision-making and care delivery.En bloc resection of bladder tumors is associated with lower intraoperative complications than and superior histopathological information to the conventional resection technique. However, the absence of a difference in oncological outcomes underscores the influence of factors such as tumor characteristics, surgeon expertise, and postoperative care on subsequent events.Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.