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The clinical study of en Bloc transurethral resection with 980a??nm Laser for treatment of primary non-muscle invasive bladder cancer
摘要： OBJECTIVE: To elevate safety and ef?cacy of en bloc transurethral resection with 980 nm laser as treatment for primary non-muscle-invasive bladder cancer (NMIBC). METHODS: Total 84 cases were enrolled in this study. Among them, 36 and 48 cases underwent treatment using the 980 nm laser and the traditional TUR-BT procedure, respectively. The peri-operative characteristics (tumor size, tumor multiplicity, tumor grade, etc.) and intra-operative complications (obturator nerve re?ex, bladder perforation, bladder irrigation, etc.) were recorded and compared between the two groups. RESULTS: There are no signi?cant difference in baseline characteristics between laser and TUR-Bt treatment groups. Operation time also has no signi?cant difference in two groups. Obturator nerve re?ex and bladder perforation were noted in 6 patients and in 3 patients during TUR-Bt group, respectively. No obturator nerve re?ex and bladder perforation were observed in the laser group. The patients who need bladder irrigation was lower in laser group than in TUR-Bt group. There were no signi?cant differences in catheterization time and hospitalization time between two groups. No signi?cant difference in the overall recurrence rate were observed among the two groups during the follow-up periods. CONCLUSION: En bloc transurethral resection using 980 nm laser is an effective and safe treatment option for non- muscle-invasive bladder cancer. Compared to the traditional TUR-Bt procedure, the procedure using 980 nm laser has fewer perioperative complications and similar oncological results.
关键词： 980 nm laser,en Bloc,non-muscle invasive bladder cancer
更新于2025-09-23 15:21:01
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DaBlaCa-11: Photodynamic diagnosis in flexible cystoscopy - initial findings in a randomized controlled trial
摘要： Patients with non-muscle invasive bladder cancer (NMIBC) face the risk of having several transurethral resections of the bladder (TURBT) performed because of the high recurrence rate of the disease. Photodynamic diagnosis (PDD) is recommended in primary TURBTs because of a higher detection rate than white light (WL) cystoscopy. In the surveillance program, however, WL flexible cystoscopy is still the standard approach. The aim of this randomized controlled trial is to examine the potential benefits from a PDD guided flexible cystoscopy in the outpatient clinic in patients with previous NMIBC. From February 2016 to September 2017, 605 patients were enrolled from three urological department in Denmark. All patients were scheduled for a routine surveillance cystoscopy following a TURBT because of Ta bladder cancer (low or high grade) 4 months earlier. Patients were randomized 1:1 to either an intervention group where Hexaminolevulinate (Hexvix?Photocure, NO) was instilled in the bladder one hour before the cystoscopy with PDD video cystoscope (PDD 11272 VPI, D-Light C-Light Source; Karl Storz), or a control group where cystoscopy was performed with WL flexible cystoscope. In both patient groups, detection of multiple and large recurrences estimated > 1 cm were scheduled for a TURBT in general anesthesia whereas solitary or small multiple recurrences, as well as suspect mucosa, were biopsied or fulgurated directly in the flexible procedure. A total of 304 patients were allocated to the intervention group (flexible PDD) and 301 to the control group (flexible WL). Approximately half of all patients in both groups were recurrence free (control group, n= 150 and intervention group, n=157). The number of patients undergoing biopsy or fulguration because of suspect mucosa were higher in the intervention group compared to the control group (n=66 vs. n=36, p<0.05). Significantly more patients in the intervention group were treated in the outpatient clinic (n=95) compared to the control group (n=76) (n=95 vs n=76, p <0.05), whereas fewer patients were scheduled for a TURBT in the intervention group (n=52) than in the control group (n=75) (n=52 vs n=75, p<0.05). These initial results indicate that PDD guided flexible cystoscopy can reduce the need of TURBT when biopsy and fulguration of small tumors is possible in the outpatient clinic. Further follow-up data on recurrences in patients in the study will be needed to estimate the clinical impact on this regarding reduction of recurrence risk and repeated procedures.
关键词： randomized controlled trial,flexible cystoscopy,Photodynamic diagnosis,non-muscle invasive bladder cancer
更新于2025-09-23 15:19:57
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The effect of holmium laser resection versus standard transurethral resection on non-muscle-invasive bladder cancer: a systematic review and meta-analysis
摘要： To explore the advantages and limitations of holmium laser resection of the bladder tumor (HOLRBT) versus standard transurethral resection of the bladder tumor (TURBT) in the treatment of non-muscle-invasive bladder cancer (NMIBC), the eligible studies were selected from the following databases: PubMed, Cochrane Library, and Embase. Studies comparing HOLRBT and TURBT for patients with NMIBC were included. The outcomes of interest were time of operation, catheterization and hospitalization, rates of recurrence, and perioperative complications, including obturator nerve reflex, bladder perforation, bladder irritation, and urethral stricture. Results of all data were compared and analyzed by Review Manager 5.3. A total of 9 comparative studies were finally included for this analysis. Pooled data demonstrated that HOLRBT significantly reduced the time to catheterization and hospitalization, the rate of recurrence in 2 years of follow-up, obturator nerve reflex, bladder perforation, and bladder irritation, compared with those in TURBT, respectively. However, no significant difference found between HOLRBT and TURBT in the time of operation, rate of recurrence in 1-year follow-up, and urethral stricture. The results of this research reached that HOLRBT would be a better choice than TURBT for patients with NMIBC.
关键词： Non-muscle-invasive bladder cancer,Meta-analysis,Transurethral resection,Holmium laser
更新于2025-09-19 17:13:59