Xu Yansheng, Guan Weimin, Chen Weihao, Xie Changliang, Ouyang Yun, Wu Yiguang, Liu Cuilong
Department of Urology, Navy General Hospital of the People's Liberation Army, No. 6 Fucheng Street, Haidian District, Beijing, 100048, People's Republic of China.
Lasers Surg Med. 2015 Apr;47(4):306-11. doi: 10.1002/lsm.22342. Epub 2015 Apr 9.
In urology, potassium-titanyl-phosphate (KTP) laser is mainly used in the treatment of benign prostatic hyperplasia with a low rate of intraoperative and postoperative complications. A prospective, randomized study was undertaken to investigate the treatment outcomes of KTP laser vaporization for primary non-muscle-invasive bladder tumors (NMIBTs) as compared with conventional monopolar transurethral resection of bladder tumors (TURBT).
This study was designed as a prospective, randomized trial. After institutional review board approval, 229 consecutive patients with NMIBTs were randomized to 2 groups. Among them, 116 patients underwent KTP laser vaporization of a bladder tumor (laser group) and 113 patients underwent standard transurethral electroresection of the bladder tumors using monopolar loop electrode (TURBT group). According to the prognostic factors for recurrence, all patients were divided into low, intermediate or high risk subgroups. The clinical data were recorded and compared between the two groups.
Eighty-nine patients in laser group and 94 in TURBT group were evaluable for the study end points. The preoperative characteristics of the patients were comparable in the two groups. There was no statistical difference in operation time between the two groups. Patients in the laser group had fewer perioperative complications and more patients needed bladder irrigation in the TURBT group. Compared with laser group, patients in the TURBT group had longer catheterization time and hospitalization duration. There were no statistical differences in the oncologic results in term of 2-year recurrence rates as compared between the two groups.
Our study demonstrated that using KTP laser, transurethral vaporization is an effective and safe treatment for the patients with primary NMIBT. Compared with traditional TURBT, the KTP laser surgery had fewer perioperative complications and similar oncological results.
在泌尿外科，磷酸钛氧钾（KTP）激光主要用于治疗良性前列腺增生，术中及术后并发症发生率较低。本研究进行了一项前瞻性随机研究，以探讨KTP激光汽化术治疗原发性非肌层浸润性膀胱肿瘤（NMIBT）与传统单极经尿道膀胱肿瘤切除术（TURBT）相比的治疗效果。
本研究设计为前瞻性随机试验。经机构审查委员会批准后，229例连续的NMIBT患者被随机分为两组。其中，116例患者接受膀胱肿瘤KTP激光汽化术（激光组），113例患者使用单极环形电极接受标准经尿道膀胱肿瘤电切术（TURBT组）。根据复发的预后因素，所有患者被分为低、中或高风险亚组。记录两组的临床数据并进行比较。
激光组89例患者和TURBT组94例患者可用于研究终点评估。两组患者的术前特征具有可比性。两组手术时间无统计学差异。激光组围手术期并发症较少，TURBT组更多患者需要膀胱冲洗。与激光组相比，TURBT组患者的导尿时间和住院时间更长。两组在2年复发率方面的肿瘤学结果无统计学差异。
我们的研究表明，使用KTP激光经尿道汽化术是治疗原发性NMIBT患者的一种有效且安全的方法。与传统TURBT相比，KTP激光手术围手术期并发症较少，肿瘤学结果相似。
