MP83-06 THULIUM FIBER LASER EN BLOC RESECTION OF BLADDER CANCER.

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive II1 Apr 2018MP83-06 THULIUM FIBER LASER EN BLOC RESECTION OF BLADDER CANCER. Alim Dymov, Leonid Rapoport, Andrey Vinarov, Dmitry Enikeev, Nikolay Sorokin, Roman Sukhanov, Dmitry Kislyakov, Alexandra Proskura, Akhmed Damiev, and Gregory Gololobov Alim DymovAlim Dymov More articles by this author , Leonid RapoportLeonid Rapoport More articles by this author , Andrey VinarovAndrey Vinarov More articles by this author , Dmitry EnikeevDmitry Enikeev More articles by this author , Nikolay SorokinNikolay Sorokin More articles by this author , Roman SukhanovRoman Sukhanov More articles by this author , Dmitry KislyakovDmitry Kislyakov More articles by this author , Alexandra ProskuraAlexandra Proskura More articles by this author , Akhmed DamievAkhmed Damiev More articles by this author , and Gregory GololobovGregory Gololobov More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2754AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To date en bloc resection of non-muscle-invasive bladder cancer (NMIBC) is regarded by urologists as a promising surgical option. Previous studies have shown that en bloc resection of bladder tumors (ERBT) provides a high quality specimen with a muscle layer in 96-100% of cases, while conventional transurethral resection of bladder tumors (cTURB) in only 50-86% of cases. Different energy sources can be used for ERBT (electrocautery, laser, cyber-knife). Laser energy seems to be preferable due to absence of obturator nerve reflex and very precise resection. This study aims to evaluate the feasibility, safety and efficacy of thulium fiber laser en bloc resection of NMIBC. METHODS 71 laser en bloc resections for NMIBC with thulium fiber laser (Urolase, IRE Polus, Russia) were performed from 2015 to 2016. The mean tumor size was 2.28±0.15 cm. The mean tumor number was 1,72±0.18. Tumors location: lateral bladder wall – 43%; close to ureteral orifice – 25.4%; bladder neck – 4.2%; posterior bladder wall – 19,7%; anterior bladder wall – 4.2%; bladder triangle – 3.5%. The laser settings were as follows: 1J, 10Hz, 10W. Rigid 24Ch/26Ch resectoscope and flexible cystoscope with 600 and 400 μm laser fibers were used. Operating time, specimen quality, intra- and postoperative complications (obturator nerve reflex, bladder wall perforation, bleeding), recurrence rate at 6, 12,18 months postop were evaluated. RESULTS The average operating time was 38,7±1.87 min (10 – 80 min). Detrusor muscle was present in 91.55% of specimens. However, detrusor tissue was absent only in the specimens after a couple of first procedures. No obturator nerve reflex, bladder wall perforation or significant bleeding were observed. Early mitomycin C instillation in all cases was done. Recurrence rates at 6, 12, 18 months postoperatively were 9.86%, 11.27% and 2.81%, respectively. CONCLUSIONS Thulium laser en bloc resection of bladder cancer is a safe and effective procedure for NMIBC treatment. Apparently, it gives acceptable recurrence and low complication rates providing high quality specimen for proper staging and decision-making on further management strategy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1117-e1118 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Alim Dymov More articles by this author Leonid Rapoport More articles by this author Andrey Vinarov More articles by this author Dmitry Enikeev More articles by this author Nikolay Sorokin More articles by this author Roman Sukhanov More articles by this author Dmitry Kislyakov More articles by this author Alexandra Proskura More articles by this author Akhmed Damiev More articles by this author Gregory Gololobov More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...