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钬激光切除术与标准经尿道切除术治疗非肌层浸润性膀胱癌的效果比较:系统评价和荟萃分析。

The effect of holmium laser resection versus standard transurethral resection on non-muscle-invasive bladder cancer: a systematic review and meta-analysis.

机构信息

Department of Urology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400000, China.

出版信息

Lasers Med Sci. 2020 Jul;35(5):1025-1034. doi: 10.1007/s10103-020-02972-w. Epub 2020 Jan 31.

Abstract

To explore the advantages and limitations of holmium laser resection of the bladder tumor (HOLRBT) versus standard transurethral resection of the bladder tumor (TURBT) in the treatment of non-muscle-invasive bladder cancer (NMIBC), the eligible studies were selected from the following databases: PubMed, Cochrane Library, and Embase. Studies comparing HOLRBT and TURBT for patients with NMIBC were included. The outcomes of interest were time of operation, catheterization and hospitalization, rates of recurrence, and perioperative complications, including obturator nerve reflex, bladder perforation, bladder irritation, and urethral stricture. Results of all data were compared and analyzed by Review Manager 5.3. A total of 9 comparative studies were finally included for this analysis. Pooled data demonstrated that HOLRBT significantly reduced the time to catheterization and hospitalization, the rate of recurrence in 2 years of follow-up, obturator nerve reflex, bladder perforation, and bladder irritation, compared with those in TURBT, respectively. However, no significant difference found between HOLRBT and TURBT in the time of operation, rate of recurrence in 1-year follow-up, and urethral stricture. The results of this research reached that HOLRBT would be a better choice than TURBT for patients with NMIBC.

摘要

为了探讨钬激光膀胱肿瘤切除术(HOLRBT)与标准经尿道膀胱肿瘤切除术(TURBT)治疗非肌层浸润性膀胱癌(NMIBC)的优势和局限性,从以下数据库中选择了符合条件的研究:PubMed、Cochrane Library 和 Embase。纳入了比较 HOLRBT 和 TURBT 治疗 NMIBC 患者的研究。感兴趣的结局包括手术时间、导尿管和住院时间、复发率以及围手术期并发症,包括闭孔神经反射、膀胱穿孔、膀胱刺激和尿道狭窄。使用 Review Manager 5.3 对所有数据进行比较和分析。最终共有 9 项比较研究纳入本分析。汇总数据显示,与 TURBT 相比,HOLRBT 显著缩短了导尿管和住院时间、2 年随访时的复发率、闭孔神经反射、膀胱穿孔和膀胱刺激的发生率。然而,HOLRBT 和 TURBT 在手术时间、1 年随访时的复发率和尿道狭窄方面无显著差异。本研究结果表明,HOLRBT 是治疗 NMIBC 患者的更好选择。

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