{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T19:20:48Z","timestamp":1787340048580,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the carbon footprint of the perioperative transurethral resection of bladder tumour (TURBT) pathway from decision to treat to postoperative discharge, and model potential greenhouse gas (GHG) emissions reduction strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This process\u2010based attributional cradle\u2010to\u2010grave life\u2010cycle assessment (LCA) of GHG emissions modelled the perioperative TURBT pathway at a hospital in Southwest England. We included travel, energy and water use, all reusable and consumable items, and laundry and equipment sterilisation. Resource use for 30 patients undergoing surgery was recorded to understand average GHG emissions and the inter\u2010case variability. Sensitivity analysis was performed for manufacturing location, pharmaceutical manufacturing carbon\u2010intensity, and theatre list utilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median (interquartile range) perioperative TURBT carbon footprint was 131.8\u2009(119.8\u2013153.6)\u2009kg of carbon dioxide equivalent. Major pathway categories contributing to GHG emissions were surgical equipment (22.2%), travel (18.6%), gas and electricity (13.3%), and anaesthesia\/drugs and associated adjuncts (27.0%), primarily due to consumable items and processes. Readily modifiable GHG emissions hotspots included patient travel for preoperative assessment, glove use, catheter use, irrigation delivery and extraction, and mitomycin C disposal. GHG emissions were higher for those admitted as inpatients after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This cradle\u2010to\u2010grave LCA found multiple modifiable GHG emissions hotspots. Key mitigation themes include minimising avoidable patient travel, rationalising equipment use, optimally filling operating theatre lists, and safely avoiding postoperative catheterisation and hospital admission where possible. A crucial next step is to design and deliver an implementation strategy for the environmentally sustainable changes demonstrated herein.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16477","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T06:55:45Z","timestamp":1721890545000},"page":"78-87","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The carbon footprint of the perioperative transurethral resection of bladder tumour pathway"],"prefix":"10.1111","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1736-3679","authenticated-orcid":false,"given":"Joseph B.","family":"John","sequence":"first","affiliation":[{"name":"University of Exeter Medical School  Exeter UK"},{"name":"Department of Urology Royal Devon University Healthcare NHS Foundation Trust  Exeter UK"},{"name":"Getting it Right First Time Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Collins","sequence":"additional","affiliation":[{"name":"Environmental Resources Management  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Eames","sequence":"additional","affiliation":[{"name":"Department of Urology Royal Devon University Healthcare NHS Foundation Trust  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"O\u2019Flynn","sequence":"additional","affiliation":[{"name":"Getting it Right First Time Programme NHS England  London UK"},{"name":"Department of Urology, Salford Royal Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim W.R.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Getting it Right First Time Programme NHS England  London UK"},{"name":"Department of Surgery Royal National Orthopaedic Hospital  Stanmore, London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9597-5446","authenticated-orcid":false,"given":"William K.","family":"Gray","sequence":"additional","affiliation":[{"name":"Getting it Right First Time Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"McGrath","sequence":"additional","affiliation":[{"name":"University of Exeter Medical School  Exeter UK"},{"name":"Department of Urology Royal Devon University Healthcare NHS Foundation Trust  Exeter UK"},{"name":"Getting it Right First Time Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(20)30271-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.01247"},{"key":"e_1_2_9_4_1","unstructured":"Office for Health Improvement and Disparities.Climate and health: applying all our health [Internet].2022. 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