Popov S V, Guseinov R G, Pomeshkin E V, Skryabin O N, Sivak K V, Perepelitsa V V, Lelyavina T A, Malyshev E A
Saint Petersburg GBUZ City Hospital Saint Luka, Saint Petersburg, Russia.
FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Moscow, Russia.
Urologiia. 2024 Sep(4):81-86.
To compare thulium and holmium lasers in the treatment of non-muscle invasive bladder cancer (NMIBC).
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).
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.
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.
比较铥激光和钬激光治疗非肌层浸润性膀胱癌(NMIBC)的效果。
在我们的研究中,根据治疗方法将患者分为3组。第1组(n = 27,占队列的32.14%)采用铥激光膀胱切除术,第2组(n = 25,占队列的29.76%)和第3组(n = 32,占队列的38.10%)分别采用钬激光切除术和标准经尿道切除术(TUR)。术前,所有患者均接受了标准的临床检查和影像学检查(胸部、腹部和腹膜后间隙的计算机断层扫描、骨盆的磁共振成像、膀胱镜检查、尿沉渣细胞学检查)。
铥激光手术时间为14.7±5.2分钟,钬激光手术时间为16.3±5.3分钟,而标准TUR手术时间为20.5±7.4分钟。激光切除术后的膀胱冲洗时间较短(分别为4.4±1.8、4.7±1.6和16.4±2.5小时)(p<0.001)。第1组和第2组的术后导尿时间分别为1.5±0.08天和1.6±0.08天,第3组为2.5±0.13天(p = 0.002)。在整个随访期内,铥激光和钬激光切除组的无病生存率均高于TUR组。
对于NMIBC患者,与接受TUR的患者相比,采用激光切除膀胱壁时并发症明显减少,生存率更高。