Safety and efficacy of thulium transurethral en block resection with fiber laser “Urоlaz” for treatment of non-muscle-invasive bladder cancer

Abstract

Background. The high recurrence rate after conventional transurethral resection (cTUR) for bladder cancer (BC) requires search for more effective methods of surgical treatment. Objective: to evaluate the feasibility, safety, and efficacy of cTUR versus thulium laser en bloc resection of bladder tumors using new fiber laser “Urolaz”. Materials and methods. 129 patients, who underwent surgical treatment for BC between 2015–2017 in urological department of I.M. Sechenov First Moscow State Medical University were included in the study. The cTUR were performed for 58 patients, 71 patients underwent thulium laser en bloc resection of bladder tumors. Results. The presence of detrusor muscle in specimen was 58.62 % in cTUR group and 91.55 % in thulium laser en bloc resection group respectively. Obturator nerve reflex, bladder perforation, and bleeding in thulium laser en bloc resection group were absent, therefore immediate instillation of chemotherapy was made in all these cases. Recurrence rate after 12 and 18 months after surgery in the group of en bloc resection was statistically lower compared to the cTUR group. Conclusion. The results, obtained in our study shows that thulium en bloc resection using thulium fiber laser “Urolaz” is feasible, effective and safe procedure for patients with BC. Thulium en bloc resection has a number of advantages over the cTUR: absence of obturator nerve reflex, high quality of specimen for pathological examination (presence of detrusor muscle in specimen was 91.55 %) and low recurrence rate.