Efficacy of transurethral en bloc resection of bladder tumor with 2 micrometer laser in the treatment of the high-risk elderly patients with bladder cancer under local anesthesia

Abstract

Objective To evaluated the clinical efficacy of transurethral en bloc resection of bladder tumor with 2 μm laser in the high-risk elderly patients with bladder cancer under local anesthesia. Methods All of 64 high-risk elderly patients having underwent surgical treatment from April 2015 to October 2016 were divided into 2 groups, 2 μm laser group (30 patients) and transurethral resection of bladder tumor (TURBT) group(34 group) according to surgical methods. The area and degree of pain was observed and recorded using visual analogue scales (VAS) during the 2 μm laser operation. The operation time, bladder irrigation time, catheter indwelling time, hospital stay, complications and 1-year cumulative recurrence rate were compared between 2 groups. Results The ASA grade in 2 μm laser group was higher than that in TURBT group and there was significant difference (P 0.05). The bladder irrigation time, catheter indwelling time and hospital stay were shorter in 2 μm laser group than those in TURBT group: (40.00 ± 19.06) h vs. (56.47 ± 14.55) h, (4.33 ± 1.40) d vs. (5.65 ± 0.93) d, (4.13 ± 1.51) d vs. (6.24 ± 0.75) d, P<0.05 or<0.01. The overall incidence of complications was lower in 2 μm laser group than that in TURBT group: 13.33%(4/30) vs. 64.71% (22/34), χ2 = 8.719, P = 0.003. Compared with that of pre-treatment, the quality of life was higher after treatment in two groups, but there were no significant differences between the two groups. There were no significant differences in 1-year cumulative recurrence rate between the two groups after treatment (χ2 = 0.496, P = 0.481). Conclusions Transurethral 2 μm laser treatment in bladder cancer under urethral surface anesthesia is safe and reliable for the high-risk elderly patients and complications are fewer than TURBT. The recent curative effect is satisfied. Key words: Bladder tumor; Transurethral resection of bladder tumor; Lasers