V8-12 EN BLOC THULIUM LASER RESECTION OF BLADDER TUMORS: INDICATIONS, SURGICAL TIPS, AND 3-YR ONCOLOGIC OUTCOMES

Introduction: The thulium laser resection of bladder tumors (TmLRBT) was increasingly used in the treatment of non-muscle-invasive bladder cancer (NMIBC) recently, and here we report the relevant outcomes of our institution to evaluate its efficacy and safety. Methods: We retrospectively collected the data of NMIBC patients who underwent either TmLRBT or transurethral resection of bladder tumor (TURBT). The baseline characteristics and perioperative outcomes were compared in these 2 groups. Results: The TmLRBT had a higher rate of detrusor identification than TURBT (97.4 vs. 87.6%, p = 0.001). After screening, 134 patients who underwent TmLRBT and 152 patients who received TURBT were enrolled in the analysis, and their baseline characteristics were similar. During the TURBT, 24 (15.8%) obturator nerve reflexes and 9 (5.9%) bladder perforations occurred, while none happened during the TmLRBT. After surgery, TmLRBT patients had fewer postoperative gross hematuria (38.1 vs. 96.7%, p < 0.001) and postoperative irrigation (27.6 vs. 92.7%, p < 0.001), and its irrigation duration was significantly shorter (2.3 vs. 3.3 day, p < 0.001). During the follow-up, no significant difference in the recurrence rate was detected (p = 0.315). Conclusions: TmLRBT is a safer technique than conventional TURBT in the treatment of NMIBC, and it could offer better specimens for pathologic assessment while the cancer control was not compromised.

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Thulium Laser Resection of Bladder Tumors vs. Conventional Transurethral Resection of Bladder Tumors for Intermediate and High Risk Non-Muscle-Invasive Bladder Cancer Followed by Intravesical BCG Immunotherapy

Frontiers in Surgery ◽

10.3389/fsurg.2021.759487 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zheng Liu ◽

Gongwei Long ◽

Yucong Zhang ◽

Guoliang Sun ◽

Wei Ouyang ◽

...

Keyword(s):

Transurethral Resection ◽

Cox Regression ◽

Recurrence Risk ◽

Perioperative Outcomes ◽

Thulium Laser ◽

Bladder Tumors ◽

Laser Resection ◽

Bcg Immunotherapy ◽

Intravesical Bcg ◽

Muscle Invasive

Background: Thulium laser resection of bladder tumors (TmLRBT) is recently considered as a common treatment option for non-muscle-invasive bladder cancers (NMIBC), but whether it is superior to Transurethral resection of bladder tumors (TURBT) are still undetermined.Materials and Methods: We retrospectively screened our institution database to identify patients who were treated by conventional TURBT or TmLRBT for NMIBC and followed by intravesical bacillus Calmette-Guérin (BCG) immunotherapy. The preoperative characteristics, perioperative outcomes, and recurrence-free survival were compared to assess the safety and efficacy of the two procedures.Results: Eventually, 90 patients who underwent TmLRBT (n = 37) or TURBT (n = 53) followed by intravesical BCG immunotherapy were included. Two groups were similar in baseline characteristics except for the smaller tumor size of the TmLRBT group(1.7 cm vs. 2.2 cm; P = 0.036). Obturator nerve reflex occurred in eight patients in the TURBT group and 3 of them suffered from bladder perforation while none happened in the TmLRBT group. The TmLRBT also had a shorter irrigation duration. In the multivariate Cox regression, the TmLRBT was related to less recurrence risk (HR: 0.268; 95% CI, 0.095–0.759; P = 0.013).Conclusion: Our results suggested that TmLRBT is safer than conventional TURBT with fewer perioperative complications, and it offers better cancer control, therefore might be a superior option for NMIBC patients with intermediate and high recurrence risk.

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1777 EN BLOC THULIUM LASER RESECTION OF BLADDER CANCER: POSSIBLE FUTURE STANDARD?

The Journal of Urology ◽

10.1016/j.juro.2013.02.2867 ◽

2013 ◽

Vol 189 (4S) ◽

Author(s):

GIOVANNI MUTO ◽

LEONARDO D'URSO ◽

EMANUELE CASTELLI ◽

DEVIS COLLURA ◽

ALESSANDRO GIACOBBE

Keyword(s):

Bladder Cancer ◽

Thulium Laser ◽

En Bloc ◽

Laser Resection

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Safety and efficacy of thulium laser resection of bladder tumors versus transurethral resection of bladder tumors: a systematic review and meta-analysis

Lasers in Medical Science ◽

10.1007/s10103-021-03272-7 ◽

2021 ◽

Author(s):

Gongwei Long ◽

Yucong Zhang ◽

Guoliang Sun ◽

Wei Ouyang ◽

Zheng Liu ◽

...

Keyword(s):

Systematic Review ◽

Transurethral Resection ◽

Meta Analysis ◽

Thulium Laser ◽

Bladder Tumors ◽

Safety And Efficacy ◽

Laser Resection

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Two-micrometer thulium laser resection of the prostate-tangerine technique for patients with acute urinary retention

Lasers in Medical Science ◽

10.1007/s10103-013-1474-3 ◽

2013 ◽

Vol 29 (3) ◽

pp. 1093-1098 ◽

Cited By ~ 9

Author(s):

Jian Zhuo ◽

Hai-Bin Wei ◽

Fu-Jun Zhao ◽

Feng Sun ◽

Bang-Min Han ◽

...

Keyword(s):

Urinary Retention ◽

Acute Urinary Retention ◽

Thulium Laser ◽

Laser Resection

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ASO Visual Abstract: Radical Hemiscrotectomy and En Bloc Orchidectomy—Surgical Technique, Perioperative and Oncologic Outcomes of a Supra-Regional UK Referral Centre

Annals of Surgical Oncology ◽

10.1245/s10434-021-10357-8 ◽

2021 ◽

Author(s):

Christian D. Fankhauser ◽

Allaudin Issa ◽

Esther W. C. Lee ◽

Christoph Oing ◽

Pedro Oliveira ◽

...

Keyword(s):

Surgical Technique ◽

Oncologic Outcomes ◽

Referral Centre ◽

En Bloc

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EN BLOC RESECTION OF BLADDER TUMOR(EBRT) USING MONOPOLAR CAUTERY; A TERTIARY HOSPITAL EXPERIENCE.

10.36106/ijar/8300518 ◽

2021 ◽

pp. 15-16

Author(s):

Neeraj Agarwal ◽

Bhuwan kumar ◽

Prashant Gupta ◽

Govind Sharma ◽

Shivam Priyadarshi

Keyword(s):

Bladder Cancer ◽

Correct Diagnosis ◽

En Bloc Resection ◽

Tertiary Hospital ◽

Complete Resection ◽

High Rate ◽

Severe Bleeding ◽

Detrusor Muscle ◽

Bladder Tumors ◽

En Bloc

Bladder cancer is a growing health problem with the second most common urological malignancy. It accounts for around 7% of a new cancer diagnosis. Tobacco smoking is the most important risk factor accounting for around 50% of cases. Tobacco smokes contain aromatic amines and polycyclic hydrocarbons which are excreted through kidneys. The goal of transurethral biopsy in NMIBC(non-muscle invasive bladder cancer) is to make the correct diagnosis and completely remove all visible lesions which can be either resected piecemeal or en bloc. The presence of detrusor muscle in the specimen is an important factor for planning treatment and prognosis. Here we share our experience of EBRT using monopolar cautery describing the feasibility, safety, and adequacy of the procedure in the management of small urinary bladder tumors. The study was conducted in the Department of Urology, SMS Medical College, and attached hospitals. All the patients with clinical NMIBC during study duration were admitted and a total of 25 patients above the age of 18yrs, having papillary bladder tumors less than 3 cm were included in the study. Complete resection by the en bloc technique was achieved in all 25 cases with no requirement of conversion to conventional TURBT. Our study also shows the presence of detrusor muscle in 22 specimens out of 25. And only two patients developed severe bleeding which needed a blood transfusion. Thus, ERBT using monopolar cautery is safe and feasible for the complete resection of NMIBCs with a high rate of detrusor-positive specimens in the selected patient population.

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