Holmium laser versus conventional transurethral resection of the bladder tumor
Teng JF, Wang K, Yin L, Qu FJ, Zhang DX, Cui XG, Xu DF. Chin Med J (Engl). 2013 May;126(9):1761-5.

Source

Department of Urology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. Department of Urology, General Hospital of Beijing Military Rejion, Beijing 100700, China.

Abstract

BACKGROUND:

Transurethral resection of the bladder tumor (TURBT) remains the gold standard for non-muscle-invasive bladder cancer (NMIBC). Laser techniques have been widely used in urology. This analysis aimed to assess the safety and efficacy of holmium resection of the bladder tumor (HoLRBT) vs. TURBT.

METHODS:

A systemic search of MEDLINE, Embase, Web of Science, and The Cochrane Library as well as manual bibliography searches were performed to identify the relevant studies. The pooled estimates of operation time, obturator nerve reflex rate, bladder perforation rate, bladder irrigation rate, catheterization time, hospital stay, and one- and two-year recurrence free survivals were calculated.

RESULTS:

Five studies were enrolled into our meta-analysis. No significant difference was observed in the operation time between groups (weighted mean difference (WMD) 1.01, 95% confidential interval (95%CI) -3.52 - 5.54, P = 0.66). The significant difference in the obturator nerve reflex (OR 0.05, 95%CI 0.01 - 0.04, P = 0.004), bladder perforation (OR 0.14, 95%CI 0.03 - 0.61, P = 0.009), bladder irrigation (OR 0.13, 95%CI 0.04 - 0.45, P = 0.001), catheterization time (WMD -0.96, 95%CI -1.11 to -0.82, P < 0.00001), and hospital stay (WMD -1.46, 95%CI -1.65 to -1.27, P < 0.00001) showed advantages of HoLRBT over TURBT. The 2-year recurrence free survival rate favors the HoLRBT group (OR 1.46, 95%CI 1.02 - 2.11, P = 0.04).

CONCLUSIONS:

As a promising technique, HoLRBT is safe and efficient, and showed several advantages over TURBT. HoLRBT can be used as an alternative procedure for TURBT in terms of low-grade papillary urothelial carcinoma or low-grade early TNM-stage urothelial carcinoma.