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Safety, feasibility, and quality of holmium laser en-bloc resection of nonmuscle invasive bladder tumors - A single-center experience.
Indian J Urol. 2020 Apr-Jun; 36(2):106-111.IJ

Abstract

Introduction

Conventional transurethral resection of bladder tumor (cTURBT), despite its piecemeal resection and associated limitations, remains the most widely practiced technique of TURBT. Resecting the tumor in a single piece would avoid most of the drawbacks of cTURBT. Our objective was to assess the feasibility, safety, and quality of Holmium (Ho) laser en-bloc resection (ERBT) for nonmuscle-invasive bladder cancer (NMIBC).

Materials and Methods

We retrospectively studied 67 patients who underwent Ho laser EBRT for primary NMIBC. Data were collected regarding tumor size, number and location, intraoperative complications, and postoperative course. Patients were grouped as first 20, next 20 (21-40), and last 27 cases to assess how the quality of resection improved with increasing experience.

Results

The mean tumor size was 28.7 ± 7.9 mm, with 34.3% of the patients having a tumor larger than 3 cm. While 43 patients (64.17%) had a single tumor, the rest had multiple tumors, ranging from 2 to 9 in number. The mean total duration of resection was 38.7 ± 11.6 min. No case required conversion to cTURBT. No patient experienced obturator reflex or bladder perforation. Detrusor muscle was present in 85.07% of the resections. With increasing experience, requirement for bladder irrigation and the incidence of postoperative clot evacuation decreased (P < 0.0001 and P = 0.31, respectively), and the detrusor-positive rate in the specimen increased (P = 0.24). The mean duration of catheterization was 1.76 ± 0.54 days.

Conclusion

Ho laser ERBT is safe and feasible for complete resection of NMIBCs with no risk of obturator-nerve reflex and a high rate of detrusor-positive specimens.

Authors+Show Affiliations

Department of Urology, Fortis Hospital Mulund, Mumbai, Maharashtra, India.Department of Urology, Fortis Hospital Mulund, Mumbai, Maharashtra, India.Department of Urology, Fortis Hospital Mulund, Mumbai, Maharashtra, India.Department of Urology, Fortis Hospital Mulund, Mumbai, Maharashtra, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32549661

Citation

Maheshwari, Pankaj N., et al. "Safety, Feasibility, and Quality of Holmium Laser En-bloc Resection of Nonmuscle Invasive Bladder Tumors - a Single-center Experience." Indian Journal of Urology : IJU : Journal of the Urological Society of India, vol. 36, no. 2, 2020, pp. 106-111.
Maheshwari PN, Arora AM, Sane MS, et al. Safety, feasibility, and quality of holmium laser en-bloc resection of nonmuscle invasive bladder tumors - A single-center experience. Indian J Urol. 2020;36(2):106-111.
Maheshwari, P. N., Arora, A. M., Sane, M. S., & Jadhao, V. G. (2020). Safety, feasibility, and quality of holmium laser en-bloc resection of nonmuscle invasive bladder tumors - A single-center experience. Indian Journal of Urology : IJU : Journal of the Urological Society of India, 36(2), 106-111. https://doi.org/10.4103/iju.IJU_348_19
Maheshwari PN, et al. Safety, Feasibility, and Quality of Holmium Laser En-bloc Resection of Nonmuscle Invasive Bladder Tumors - a Single-center Experience. Indian J Urol. 2020 Apr-Jun;36(2):106-111. PubMed PMID: 32549661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety, feasibility, and quality of holmium laser en-bloc resection of nonmuscle invasive bladder tumors - A single-center experience. AU - Maheshwari,Pankaj N, AU - Arora,Amandeep Manjeet, AU - Sane,Mahesh S, AU - Jadhao,Vivek Ganesh, Y1 - 2020/04/07/ PY - 2019/12/07/received PY - 2020/03/18/revised PY - 2020/03/18/accepted PY - 2020/6/19/entrez PY - 2020/6/19/pubmed PY - 2020/6/19/medline SP - 106 EP - 111 JF - Indian journal of urology : IJU : journal of the Urological Society of India JO - Indian J Urol VL - 36 IS - 2 N2 - Introduction: Conventional transurethral resection of bladder tumor (cTURBT), despite its piecemeal resection and associated limitations, remains the most widely practiced technique of TURBT. Resecting the tumor in a single piece would avoid most of the drawbacks of cTURBT. Our objective was to assess the feasibility, safety, and quality of Holmium (Ho) laser en-bloc resection (ERBT) for nonmuscle-invasive bladder cancer (NMIBC). Materials and Methods: We retrospectively studied 67 patients who underwent Ho laser EBRT for primary NMIBC. Data were collected regarding tumor size, number and location, intraoperative complications, and postoperative course. Patients were grouped as first 20, next 20 (21-40), and last 27 cases to assess how the quality of resection improved with increasing experience. Results: The mean tumor size was 28.7 ± 7.9 mm, with 34.3% of the patients having a tumor larger than 3 cm. While 43 patients (64.17%) had a single tumor, the rest had multiple tumors, ranging from 2 to 9 in number. The mean total duration of resection was 38.7 ± 11.6 min. No case required conversion to cTURBT. No patient experienced obturator reflex or bladder perforation. Detrusor muscle was present in 85.07% of the resections. With increasing experience, requirement for bladder irrigation and the incidence of postoperative clot evacuation decreased (P < 0.0001 and P = 0.31, respectively), and the detrusor-positive rate in the specimen increased (P = 0.24). The mean duration of catheterization was 1.76 ± 0.54 days. Conclusion: Ho laser ERBT is safe and feasible for complete resection of NMIBCs with no risk of obturator-nerve reflex and a high rate of detrusor-positive specimens. SN - 0970-1591 UR - https://www.unboundmedicine.com/medline/citation/32549661/Safety,_feasibility,_and_quality_of_holmium_laser_en-bloc_resection_of_nonmuscle_invasive_bladder_tumors_-_A_single-center_experience L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32549661/ DB - PRIME DP - Unbound Medicine ER -
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