Consensus-Based Development of a Surgical Checklist for Transurethral Resection of Bladder Tumor: An Initiative of the Japanese Society of Urologic Oncology.

چکیده اصلی

OBJECTIVE: This study aimed to develop a nationwide, consensus-based surgical checklist to standardize transurethral resection of bladder tumor procedures and documentation. METHODS: In 2025, the Japanese Society of Urologic Oncology convened a working group of 20 bladder cancer specialist urologists to develop a national surgical checklist for transurethral resection of bladder tumors. A 12-member steering committee reviewed available evidence and proposed 30 candidate items. Using a modified Delphi approach, all members rated each item online, with consensus predefined as ≥ 75% agreement. Iterative revisions incorporating public comments and external expert input produced the final checklist. RESULTS: The final checklist comprised 22 items across four sections: (i) preoperative patient and tumor information (recurrence status; upper tract urothelial carcinoma; urine cytology; clinical Tumor-Node-Metastasis staging; performance status; factors affecting surgery/anesthesia); (ii) surgical and anesthetic planning (surgical intent; resection technique; adjunctive imaging modality; additional biopsies; anesthesia method; obturator reflex prophylaxis); (iii) intraoperative tumor and resection information (tumor number; index tumor morphology; index tumor size; findings suggestive of carcinoma in situ; extent of tumor resection; detrusor muscle visible; muscle invasion suspected); and (iv) complications and adjuvant therapy (urethral stricture; intraoperative complications; immediate single instillation). An additional section provides two bladder diagrams: a male/general-use version with lower urinary tract annotations and a female-specific version, both designed for mapping tumor location, characteristics, and operative findings. CONCLUSIONS: This checklist provides a practical framework to standardize transurethral resection of bladder tumor practice and documentation and support safe, high-quality care, warranting prospective evaluation of feasibility, adherence, and quality indicators/outcomes.

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