<正>Objective:To observe the advantage of total intravenous anesthesia for transurethral resec- tion of bladder tumor(TURBT).Methods:Sixty ASAⅠ-Ⅱpatients undergoing TURBT were randomly assigned to 2groups.Spin...<正>Objective:To observe the advantage of total intravenous anesthesia for transurethral resec- tion of bladder tumor(TURBT).Methods:Sixty ASAⅠ-Ⅱpatients undergoing TURBT were randomly assigned to 2groups.Spinal anesthesia with 0.75% purebupivacaine(8-12mg)was applied to patients in GroupⅠ(n=30).Patients in GroupⅡ(n=30)received total intravenous anesthesia with continuous in- fusion of Propofol and Remifentanil;and a laryngeal mask was used to ensure the airway and ventilation. BP,HR,SPO_2 and pertinent side effects were monitored and recorded.Results:The patients in groupⅡexperienced more stable hemodynamics than those in groupⅠ.Obturator nerve reflex was observed in 15 (50.0~%)patients in GroupⅠ,but none(0%)in GroupⅡ(P<0.01).Conclusion:Total intravenous anesthesia with laryngeal mask is a safe,reliable,controllable and simple manual for patient undergoing TURBT.展开更多
BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a ...BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARY This paper reports a case of intravesical explosion during TUR-BT.Combined with the literature review,the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSION Although rare,intravesical explosions can cause serious consequences,and the loud explosion can also lead to a profound psychological shadow on the patient.Urologists must be aware of this potential complication.Careful operative techniques and special precautions can reduce the risk of this complication.展开更多
Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at...Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.展开更多
Objective:Guidelines for muscle-invasive bladder cancer(MIBC)recommend that patients receive neoadjuvant chemotherapy with radical cystectomy as treatment over radical cystectomy alone.Though trends and practice patte...Objective:Guidelines for muscle-invasive bladder cancer(MIBC)recommend that patients receive neoadjuvant chemotherapy with radical cystectomy as treatment over radical cystectomy alone.Though trends and practice patterns of MIBC have been defined using the National Cancer Database,data using the Surveillance,Epidemiology,and End Results(SEER)program have been poorly described.Methods:Using the SEER database,we collected data of MIBC according to the American Joint Commission on Cancer.We considered differences in patient demographics and tumor charac-teristics based on three treatment groups:chemotherapy(both adjuvant and neoadjuvant)with radical cystectomy,radical cystectomy,and chemoradiotherapy.Multinomial logistic regression was performed to compare likelihood ratios.Temporal trends were included for each treatment group.Kaplan-Meier curves were performed to compare cause-specific sur-vival.A Cox proportional-hazards model was utilized to describe predictors of survival.Results:Of 16728 patients,10468 patients received radical cystectomy alone,3236 received chemotherapy with radical cystectomy,and 3024 received chemoradiotherapy.Patients who received chemoradiotherapy over radical cystectomy were older and more likely to be African American;stage III patients tended to be divorced.Patients who received chemotherapy with radical cystectomy tended to be males;stage II patients were less likely to be Asian than Caucasian.Stage III patients were less likely to receive chemoradiotherapy as a treatment op-tion than stage II.Chemotherapy with radical cystectomy and chemoradiotherapy are both un-derutilized treatment options,though increasingly utilized.Kaplan-Meier survival curves showed significant differences between stage II and III tumors at each interval.A Cox proportional-hazards model showed differences in gender,tumor stage,treatment modality,age,andmarital status.Conclusion:Radical cystectomy alone is still the most commonly used treatment for muscle-invasive bladder cancer based on temporal trends.Significant disparities exist in those who receive radical cystectomy over chemoradiotherapy for treatment.展开更多
Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management...Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions.展开更多
Bladder tumor is characterized by recurrent recurrence and distant metastasis,which determines the difficulty of completely curing bladder tumor.In recent years,the number of patients with bladder cancer is increasing...Bladder tumor is characterized by recurrent recurrence and distant metastasis,which determines the difficulty of completely curing bladder tumor.In recent years,the number of patients with bladder cancer is increasing,and the treatment of bladder cancer has become an important direction of clinical research.It is difficult to control bladder tumor by traditional therapy.Photodynamic therapy(PDT),as a new optical therapy,has gradually become the main method in clinical treatment of bladder tumor combined with transurethral resection of bladder tumor.In this paper,a patient with superficial recurrent bladder tumor was treated by photodynamic therapy combined with transurethral resection of bladder tumor.The advantages of photodynamic therapy in the treatment of bladder tumor and the selection of photosensitizer in the process of photodynamic therapy were discussed.After two recurrences,the patients chose photodynamic therapy.The tumors were resected one by one,and the wound was coagulated by roller electrode.After the drug was retained for 20 minutes,the bladder was empty.The spherical optical fiber was implanted into the bladder.The photodynamic energy was adjusted(light power 1.8 W,light time 1302 s).There was no recurrence after operation.Most bladder tumors are superficial tumors,and bladder is a cavity organ,which determines that bladder is an ideal organ for photodynamic therapy.As a targeted drug,photosensitizer is only absorbed by bladder tumor after being perfused into bladder.The photosensitizer forms reactive oxygen species through oxygen and kills tumor cells.Clinical practice has proved that PDT has its unique advantages for superficial and recurrent bladder tumors.As the first generation photosensitizer,xipofen also has selectivity in the treatment of bladder cancer.展开更多
目的探讨微信平台健康教育对膀胱癌患者术后生活质量与日常生活活动能力的影响。方法选取2021年1月至2022年10月于连云港市第二人民医院行经尿道膀胱肿瘤电切术的膀胱癌患者68例,根据出院时间先后顺序分为试验组与对照组,每组34例。对...目的探讨微信平台健康教育对膀胱癌患者术后生活质量与日常生活活动能力的影响。方法选取2021年1月至2022年10月于连云港市第二人民医院行经尿道膀胱肿瘤电切术的膀胱癌患者68例,根据出院时间先后顺序分为试验组与对照组,每组34例。对照组患者采用常规延续性护理,试验组患者在此基础上采用微信平台健康教育,比较2组患者的健康认知问卷评分、日常生活活动能力量表(ADL)、自我护理能力量表、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、生活质量(SF-36量表)。结果与对照组相比,试验组患者干预后的健康认知评分包括药物认知评分、疾病认知评分、健康生活方式评分及生活能力评分均明显较高,差异有统计学意义(P<0.05)。与对照组的自我护理能力评分相比,试验组明显较高,差异有统计学意义(P<0.05)。干预结束1 d,2组患者HAMD、HAMA评分较干预前下降;且与对照组相比,试验组患者干预结束1 d HAMD、HAMA评分均较低(P<0.05)。与对照组相比,试验组患者干预后的生活质量评分包括躯体功能评分、心理功能评分、社会功能评分明显较高,差异有统计学意义(P<0.05)。结论微信平台健康教育可提高膀胱癌患者术后健康认知,提高患者的自护水平和生活能力,改善患者心理状态与生活质量,干预效果良好,值得推荐。展开更多
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 a...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% C1-1.11 to-0.82, P 〈0.00001), and hospital stay (WMD-1.46, 95% C1-1.65 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.展开更多
Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the co...Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.展开更多
文摘<正>Objective:To observe the advantage of total intravenous anesthesia for transurethral resec- tion of bladder tumor(TURBT).Methods:Sixty ASAⅠ-Ⅱpatients undergoing TURBT were randomly assigned to 2groups.Spinal anesthesia with 0.75% purebupivacaine(8-12mg)was applied to patients in GroupⅠ(n=30).Patients in GroupⅡ(n=30)received total intravenous anesthesia with continuous in- fusion of Propofol and Remifentanil;and a laryngeal mask was used to ensure the airway and ventilation. BP,HR,SPO_2 and pertinent side effects were monitored and recorded.Results:The patients in groupⅡexperienced more stable hemodynamics than those in groupⅠ.Obturator nerve reflex was observed in 15 (50.0~%)patients in GroupⅠ,but none(0%)in GroupⅡ(P<0.01).Conclusion:Total intravenous anesthesia with laryngeal mask is a safe,reliable,controllable and simple manual for patient undergoing TURBT.
文摘BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARY This paper reports a case of intravesical explosion during TUR-BT.Combined with the literature review,the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSION Although rare,intravesical explosions can cause serious consequences,and the loud explosion can also lead to a profound psychological shadow on the patient.Urologists must be aware of this potential complication.Careful operative techniques and special precautions can reduce the risk of this complication.
文摘Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.
文摘Objective:Guidelines for muscle-invasive bladder cancer(MIBC)recommend that patients receive neoadjuvant chemotherapy with radical cystectomy as treatment over radical cystectomy alone.Though trends and practice patterns of MIBC have been defined using the National Cancer Database,data using the Surveillance,Epidemiology,and End Results(SEER)program have been poorly described.Methods:Using the SEER database,we collected data of MIBC according to the American Joint Commission on Cancer.We considered differences in patient demographics and tumor charac-teristics based on three treatment groups:chemotherapy(both adjuvant and neoadjuvant)with radical cystectomy,radical cystectomy,and chemoradiotherapy.Multinomial logistic regression was performed to compare likelihood ratios.Temporal trends were included for each treatment group.Kaplan-Meier curves were performed to compare cause-specific sur-vival.A Cox proportional-hazards model was utilized to describe predictors of survival.Results:Of 16728 patients,10468 patients received radical cystectomy alone,3236 received chemotherapy with radical cystectomy,and 3024 received chemoradiotherapy.Patients who received chemoradiotherapy over radical cystectomy were older and more likely to be African American;stage III patients tended to be divorced.Patients who received chemotherapy with radical cystectomy tended to be males;stage II patients were less likely to be Asian than Caucasian.Stage III patients were less likely to receive chemoradiotherapy as a treatment op-tion than stage II.Chemotherapy with radical cystectomy and chemoradiotherapy are both un-derutilized treatment options,though increasingly utilized.Kaplan-Meier survival curves showed significant differences between stage II and III tumors at each interval.A Cox proportional-hazards model showed differences in gender,tumor stage,treatment modality,age,andmarital status.Conclusion:Radical cystectomy alone is still the most commonly used treatment for muscle-invasive bladder cancer based on temporal trends.Significant disparities exist in those who receive radical cystectomy over chemoradiotherapy for treatment.
基金suppor ted by the National Key Research and Development Plan of China(Technology helps Economy 2020,2016YFC0106300)the National Natural Science Foundation of China(82174230)the Major Program Fund of Technical Innovation Project of Department of Science and Technology of Hubei Province(2016ACAl52)。
文摘Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions.
文摘Bladder tumor is characterized by recurrent recurrence and distant metastasis,which determines the difficulty of completely curing bladder tumor.In recent years,the number of patients with bladder cancer is increasing,and the treatment of bladder cancer has become an important direction of clinical research.It is difficult to control bladder tumor by traditional therapy.Photodynamic therapy(PDT),as a new optical therapy,has gradually become the main method in clinical treatment of bladder tumor combined with transurethral resection of bladder tumor.In this paper,a patient with superficial recurrent bladder tumor was treated by photodynamic therapy combined with transurethral resection of bladder tumor.The advantages of photodynamic therapy in the treatment of bladder tumor and the selection of photosensitizer in the process of photodynamic therapy were discussed.After two recurrences,the patients chose photodynamic therapy.The tumors were resected one by one,and the wound was coagulated by roller electrode.After the drug was retained for 20 minutes,the bladder was empty.The spherical optical fiber was implanted into the bladder.The photodynamic energy was adjusted(light power 1.8 W,light time 1302 s).There was no recurrence after operation.Most bladder tumors are superficial tumors,and bladder is a cavity organ,which determines that bladder is an ideal organ for photodynamic therapy.As a targeted drug,photosensitizer is only absorbed by bladder tumor after being perfused into bladder.The photosensitizer forms reactive oxygen species through oxygen and kills tumor cells.Clinical practice has proved that PDT has its unique advantages for superficial and recurrent bladder tumors.As the first generation photosensitizer,xipofen also has selectivity in the treatment of bladder cancer.
文摘目的探讨微信平台健康教育对膀胱癌患者术后生活质量与日常生活活动能力的影响。方法选取2021年1月至2022年10月于连云港市第二人民医院行经尿道膀胱肿瘤电切术的膀胱癌患者68例,根据出院时间先后顺序分为试验组与对照组,每组34例。对照组患者采用常规延续性护理,试验组患者在此基础上采用微信平台健康教育,比较2组患者的健康认知问卷评分、日常生活活动能力量表(ADL)、自我护理能力量表、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、生活质量(SF-36量表)。结果与对照组相比,试验组患者干预后的健康认知评分包括药物认知评分、疾病认知评分、健康生活方式评分及生活能力评分均明显较高,差异有统计学意义(P<0.05)。与对照组的自我护理能力评分相比,试验组明显较高,差异有统计学意义(P<0.05)。干预结束1 d,2组患者HAMD、HAMA评分较干预前下降;且与对照组相比,试验组患者干预结束1 d HAMD、HAMA评分均较低(P<0.05)。与对照组相比,试验组患者干预后的生活质量评分包括躯体功能评分、心理功能评分、社会功能评分明显较高,差异有统计学意义(P<0.05)。结论微信平台健康教育可提高膀胱癌患者术后健康认知,提高患者的自护水平和生活能力,改善患者心理状态与生活质量,干预效果良好,值得推荐。
文摘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% C1-1.11 to-0.82, P 〈0.00001), and hospital stay (WMD-1.46, 95% C1-1.65 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.
文摘Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.