Analysis of the efficacy of transurethral thulium-Yag laser resection of bladder tumor in the treatment of non-muscle invasive bladder cancer

Abstract

Objective To evaluate the efficacy and safety of transurethral thulium-Yag laser(Tm-Yag Laser) resection of bladder tumor in the treatment of non-muscle invasive bladder cancer(NMIBC). Methods The clinical data of 186 patients who underwent transurethral resection with pathologically identified of NMIBC were retrospectively analyzed.76 cases and 110 cases were in the transurethral resection of bladder cancer Tm-Yag Laser group and TURBT group, respectively. The operative time, intraoperative blood loss, incidence of obturator nerve reflex, days for urethral catheterization, duration of hospitalization after surgery, detection rate of muscle layer in postoperative pathologic examination and recurrence between the two groups were compared. All patients were followed up for 24 months. Regularly gemcitabine intravesical instillation chemotherapy and cystoscopy were performed postoperation. Results The operative time [(27.08±5.56) min vs. (25.55±5.37) min, P>0.05] and intraoperative blood loss [(14.23±4.05) mL vs. (15.10±3.24) mL, P>0.05] showed no differences between the two groups. The incidence of obturator nerve reflex in Tm-Yag laser group was lower than that in TURBT group (0.0% vs. 5.5 %, χ2=4.28, P=0.038). The days for urethral catheterization [(3.48±1.05) d vs. (4.02±1.14) d, t=3.328, P=0.001] and the duration of hospitalization after surgery [(4.47±1.08) d vs. (5.02±1.13) d, t=3.350, P=0.001] in Tm-Yag laser group were significantly shorter than those in TURBT group. In Tm-Yag laser group, the detection rate of muscle layer in postoperative pathologic examination was higher than that in TURBT group(χ2=14.96, P=0.001). The total rate of tumor recurrence in Tm-Yag laser group was significantly lower than that in TURBT group(13.2 % vs. 25.5%, χ2=4.18, P=0.041). Conclusion Transurethral Tm-Yag laser is safe and effective in the treatment of NMIBC. It can avoid the incidence of complications and reduce tumor recurrence rate, which is worthy of promotion. Key words: Urinary bladder neoplasms; Laser therapy