局部麻醉、全身麻醉或脊髓麻醉经尿道激光消融治疗非肌肉侵袭性膀胱癌的临床结果：一项日本单中心试点研究

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2026-04-01 Epub Date: 2026-01-31 DOI:10.1016/j.pdpdt.2026.105376

Shinkuro Yamamoto , Satoshi Fukata , Sho Shimasaki , Yoshitaka Kurano , Erika Yamashita , Kaya Atagi , Ryu Shigehisa , Hiroto Osakabe , Tomoya Nao , Tsutomu Shimamoto , Hideo Fukuhara , Nobutaka Shimizu , Shingo Ashida , Keiji Inoue

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引用次数: 0

摘要

目的：比较一项日本队列研究中，表面麻醉与全身麻醉或脊髓麻醉下经尿道激光消融（TULA）治疗非肌肉浸润性膀胱癌（NMIBC）的结果。方法：我们回顾性分析了从2024年2月至2025年6月接受32次980纳米二极管激光TULA治疗的28例患者。2024年2月至10月接受全麻或脊髓麻醉下TULA治疗的患者（全麻或脊髓麻醉组，n = 14）。在2024年10月至2025年6月期间接受TULA治疗的患者采用局部利多卡因润滑（表面麻醉组，n = 18）。我们比较了人口统计学、围手术期和短期肿瘤预后。并发症按Clavien-Dindo分级。结果：两组间基线特征相似。手术时间、治疗能量、治疗时间具有可比性。表面麻醉组治疗后中位住院时间（1[1-1]比2[2-2.75]天，p < 0.001）和置管时间（0[0-0]比1[1-1]天，p < 0.001）显著缩短。并发症轻度（1-2级），全身或脊髓麻醉组1例（7.1%），表面麻醉组3例（16.7%）。在严格的随访标准（≥90天和≥180天）下，两组患者3个月无复发生存率（RFS）均为100%(14/14)，麻醉组6个月RFS为92.3%(12/13)，表面麻醉组为58.3%（7/12）。Kaplan-Meier分析显示差异无统计学意义（p = 0.19）。结论：局部麻醉下的TULA与NMIBC患者治疗后住院时间缩短和无导管恢复相关。包括短期RFS在内的早期肿瘤预后似乎很有希望；然而，这些初步的、中试规模的发现需要在更大规模的研究中进一步验证。与全身麻醉或脊髓麻醉相比，表面麻醉下的TULA可提供围手术期优势，特别是对于老年患者或有明显合并症的患者。

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Clinical outcomes following transurethral laser ablation with topical versus general or spinal anesthesia for non–muscle-invasive bladder cancer: A Japanese single-center pilot study

Objectives

To compare transurethral laser ablation (TULA) outcomes for non-muscle invasive bladder cancer (NMIBC) performed under topical anesthesia versus general or spinal anesthesia in a Japanese cohort.

Methods

We retrospectively reviewed 28 patients who underwent 32 TULA sessions with a 980-nm diode laser from February 2024 to June 2025. Patients treated between February and October 2024 received TULA under general or spinal anesthesia (general or spinal anesthesia group, n = 14). Those treated between October 2024 and June 2025 underwent TULA with topical lidocaine lubrication (topical anesthesia group, n = 18). We compared demographic, perioperative, and short-term oncologic outcomes. Complications were graded according to Clavien–Dindo classification.

Results

Baseline characteristics were similar between groups. Operation time, treatment energy, and treatment duration were comparable. The topical anesthesia group experienced a significantly shorter median post-treatment hospital stay (1 [1–1] vs. 2 [2–2.75] days; p < 0.001) and catheterization duration (0 [0–0] vs. 1 [1–1] days; p < 0.001). Complications were mild (grade 1–2), affecting one general or spinal anesthesia group patient (7.1%) and three topical anesthesia group patients (16.7%). Under strict follow-up criteria (≥90 and ≥180 days), 3-month recurrence-free survival (RFS) was 100% (14/14) in both groups, and 6-month RFS was 92.3% (12/13) in the anesthesia group vs. 58.3% (7/12) in the topical anesthesia group. Kaplan–Meier analysis showed no statistically significant difference (p = 0.19).

Conclusions

TULA under topical anesthesia for selected NMIBC patients was associated with shorter post-treatment hospital stays and a catheter-free recovery. Early oncologic outcomes, including short-term RFS, seem promising; however, these preliminary, pilot-scale findings warrant further validation in larger studies. TULA with topical anesthesia may provide perioperative advantages compared with procedures performed under general or spinal anesthesia, particularly in older patients or those with significant comorbidities.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.