Feasibilty and safety of en bloc transurethral resection with thulium-Yag laser in the management of patients with non-muscle-invasive bladder cancer / 肿瘤

ABSTRACT

Objective: To evaluate the feasibility and safety of en bloc transurethral resection with thulium (Tm)-Yag laser in the management of patients with non-muscle-invasive bladder cancer. Methods: The data of 287 consecutive patents pathologically identified of non-muscle-invasive bladder cancer, who underwent transurethral resection from January 2008 to December 2013, were retrospectively analyzed. Of these patients, 209 patients underwent the traditional transurethral resection of bladder cancer (TURBT), and the other 78 patients underwent the en bloc transurethral resection with Tm-Yag laser. The operative time, intraoperative blood loss, days for urethral catheterization, duration of hospitalization after surgery, incidence of postoperative complications, detection rate of muscle layer in postoperative pathologic examination, pathologic grade and stage, and recurrence between the two groups were compared. All the patients were followed-up, and the median follow-up time was 27 months. Results: The operative time in Tm-Yag laser group was significantly longer than that in TURBT group (75.77±52.19 min vs 47.18±35.77 min, P 0.05). The incidence of postoperative complications in Tm-Yag laser group was lower than that in TURBT group (6.4% vs 1 7.7%, P = 0.045). In Tm-Yag laser group, the number of stage Tl tumors and the detection rate of muscle layer in postoperative pathologic examination were both higher than those in TURBT group (P = 0.039; P = 0.001). The total rate of tumor recurrence and progression showed no differences between the two groups (35.9% vs 43.5%, P > 0.05; 11.5% vs 14.8%, P > 0.05). The Kaplan-Meier survival curves of recurrence-free survival and progression-free survival also showed no significant differences (both P > 0.05). Conclusion: The en bloc transurethral resection with Tm-Yag laser is feasible and safe in the management of non-muscle-invasive bladder cancer.