Safety and efficacy of Holmium laser resection for primary non-muscle invasive bladder cancer versus transurethral electroresection / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the safety and efficacy of Holmium laser resection for primary non-muscle invasive bladder cancer (HoLRBt) compared with transurethral resection of bladder tumor (TURBt). Methods Data of 212 patients with primary non-muscle invasive bladder cancer were collected retrospectively. The patients were divided into HoLRBt group(n= 101) and TURBt group (n= 111). The patients in each group were stratified into 3 risk groups (low, intermediate and high risk) according to prognostic factors for recurrence based on EAU guideline. Then, the safety of HoLRBt and TURBt groups were compared, concerning the intraoperative complications and postoperative recovery. Efficacy indicated by recurrence-free survival of the 2 groups was analyzed and compared by Kaplan-Meier technique. Results Patients' demographics including age, gender, tumor characteristics, and recurrence risk of tumor between the 2 groups were comparable(P＞0.05). No obturator nerve reflex occurred in the HoLRBt group. Meanwhile, 7 out of 111 patients in the TURBt group experienced this complication resulted bladder perforation in 3 patients. The proportion of patients needing postoperative bladder irrigation in the HoLRBt group was lower compared to the TURBt group (P＜0.05). HoLRBt was associated with shorter postoperative catheter drainage period (P＜0.05). The mean postoperative follow-up was 34 months (range 18 to 43). Recurrence-free survival after HoLRBt was similar with that of TURBt (P = 0. 283). Conclusions Compared with TURBt, HoLRBt is a feasible, safe and effective alternative for the management of primary non-muscle invasive bladder cancer with similar therapeutic efficacy and fewer perioperative complications.HoLRBt can be widely used in clinical practice in the treatment of primary non-muscle invasive bladder cancer.