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EDITORIAL COMMENT

  • Mitchell H. Bamberger
    Correspondence
    Address correspondence to Mitchell H Bamberger M.D., M.B.A., F.A.C.S., Associate Professor of Urology, University of Massachusetts Medical School, Worcester, MA 01605, 50 Memorial Drive, Suite 108, Leominster, MA 01453.
    Affiliations
    Associate Professor of Urology, University of Massachusetts Medical School, Worcester, MA 01605, 50 Memorial Drive, Suite 108, Leominster, MA
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      The authors submit a manuscript investigating peer review of surgical technique and adequate sampling of detrusor musculature during transurethral resection of bladder tumor (TURBT). This involves an academic health system of 10 hospitals with 37 surgeons. Each surgeon was invited to submit a single video resection performed without trainee involvement. Each video was evaluated by 10 reviewers. The primary intent was to assess detrusor sampling in the pathologic specimen. Those surgeons with >5 TURBTs were separately studied. The study group consisted of 13 surgeons (all male) with varying degree of experience between 0 and 31 years. There was considerable variation in detrusor sampling with a mean of 64.5%. The study group with >5 TURBTs range was between 50%-90%. Both lower technical skill and hard to reach tumor locations resulted in poorer detrusor sampling as expected. However, overall surgeon skill was not associated with detrusor sampling, although the investigators noted that sending a separate deep tumor sample was associated with higher detrusor sampling as expected. The overall outcome(s) was there was a modest success in assessing surgeon skill in obtaining detrusor sampling, and technical skill was not associated with detrusor sampling.
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