Comparison of the safety and efficacy of conventional monopolar and 2-micron laser transurethral resection in the management of multiple nonmuscle-invasive bladder cancer

J Int Med Res. 2013 Aug;41(4):984-92. doi: 10.1177/0300060513477001. Epub 2013 Jun 12.

Abstract

Objectives: To compare the safety and efficacy of conventional monopolar transurethral resection of bladder tumour (TURBT) and 2-micron continuous-wave laser resection (2-µm laser) techniques in the management of multiple nonmuscle-invasive bladder cancer (NMIBC), and to investigate long-term effects on tumour recurrence.

Methods: Patients with multiple NMIBC were randomized to receive TURBT or 2-µm laser in a nonblinded manner. All patients received intravesical chemotherapy with epirubicin (40 mg/40 ml) for 8 weeks, beginning 1 week after surgery, followed with monthly maintenance therapy for 12 months. Three-year follow-up data of preoperative, operative and postoperative management were recorded.

Results: In total, 120 patients were included: 56 in the TURBT group and 64 in the 2-µm laser group. Intra- and postoperative complications (including bladder perforation, bleeding and irritation) were less frequently observed in the 2-µm laser group compared with the TURBT group. There were no significant differences in first time to recurrence, overall recurrence or occurrence of urethral strictures.

Conclusions: The 2-µm laser resection method was more effective than TURBT in reducing rates of intra- and postoperative complications, but offered no additional benefit regarding tumour recurrence.

Keywords: 2-µm continuous-wave laser; Bladder carcinoma; TURBT; recurrence rate; transurethral resection of bladder tumour.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Carcinoma / diagnosis
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Female
  • Humans
  • Laser Coagulation / instrumentation
  • Laser Coagulation / methods*
  • Lasers
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Postoperative Complications*
  • Risk Factors
  • Survival Rate
  • Treatment Outcome
  • Urethra / pathology
  • Urethra / surgery
  • Urinary Bladder / pathology
  • Urinary Bladder / surgery*
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*