Abstract

BackgroundIn selected patients with bladder cancer, partial cystectomy is an alternative treatment for bladder preservation with fair oncologic result. During partial cystectomy, tumor margin demarcation is difficult. Various methods were adopted, however, there is no standard for tumor margin demarcation. We aimed to introduce and provide our experience with holmium laser-assisted method with ten patients.MethodsFrom March 2016 and February 2019, patients who want partial cystectomy for bladder cancer were enrolled in this study. Inclusion criteria were stage T2 or T3 disease and tumor location restricted within the dome, and lateral, posterior side of the bladder were included. Transurethral holmium laser-assisted mucosal incision was made and deepened until perivesical fat. Minimal Safety margin for 5-10 mm were spared, and tumor removal was done laparoscopically.ResultsTen patients underwent holmium laser-assisted laparoscopic partial cystectomy. All procedures were done without complication. The tumor locations were laterally in seven patients, dome in two patients, and posterior wall in one patient. Pathologic examination of surgical margin showed no cancer cell involvement in all cases. There were no recurrences or metastases for 12 months follow up.ConclusionsHolmium laser-assisted laparoscopic partial cystectomy is effective and safe technique in carefully selected patients. To achieve precise and appropriate surgical margin during the laparoscopic partial cystectomy, holmium laser resection provides feasible and safe method that assists in bladder incision with minimal ureteral orifice involvement.Trial registrationRetrospectively registered.

Highlights

  • In selected patients with bladder cancer, partial cystectomy is an alternative treatment for bladder preservation with fair oncologic result

  • We report our experience using the holmium laser-assisted laparoscopic partial cystectomy in treating patients with locally advanced bladder cancer

  • Holmium laser-assisted laparoscopic partial cystectomy was successfully performed in 10 patients

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Summary

Introduction

In selected patients with bladder cancer, partial cystectomy is an alternative treatment for bladder preservation with fair oncologic result. In selected patients with bladder cancer, partial cystectomy can obtain similar oncologic results with lower morbidity and better quality of life than radical surgery [5]. Contralateral or midline incision can be considered, and the tumor or previous transurethral resection scar might be identified from inside of bladder. This procedure can compromise the surgical margins or even go through the tumor itself and two suture lines may require for closure [6]

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