[Comparative study of thulium and holmium laser in non-muscle invasive bladder cancer].

Abstract

Aim: To compare thulium and holmium lasers in the treatment of non-muscle invasive bladder cancer (NMIBC).

Materials and methods: In our work, patients were divided into 3 groups, depending on the treatment method. In the group 1 (n=27, 32.14% of the cohort), thulium laser resection of the bladder was done, while in the group 2 (n=25, 29.76% of the cohort) and group 3 (n=32, 38.10 % of the cohort) holmium laser resection and standard transurethral resection (TUR) were performed, respectively. In the preoperative period, all patients underwent a standard clinical examinations and imaging studies (computed tomography of the thorax, abdomen and retroperitoneal space, magnetic resonance imaging of the pelvis, cystoscopy, cytological examination of urine sediment).

Results: The duration of the procedure was 14.7+/-5.2 minutes for a thulium laser and 16.3+/-5.3 minutes for a holmium laser, compared to 20.5+/-7.4 minutes for standard TUR. The duration of postoperative irrigation after laser resection was lower (4.4+/-1.8, 4.7+/-1.6 and 16.4+/-2.5 hours, respectively) (p<0.001). The period of postoperative catheterization in groups 1 and 2 was 1.5+/-0.08 and 1.6+/-0.08 days, respectively, compared to 2.5+/- 0.13 days in the group 3 (p=0.002). In the group of thulium and holmium laser resection, a higher disease-free survival was demonstrated compared with TUR throughout the entire follow-up period.

Conclusion: When performing laser resection of the bladder wall for NMIBC, a significant lower number of complications and better survival were documented compared to patients who underwent TUR.