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当前激光在膀胱肿瘤整块切除术中的应用——一篇叙述性文献综述

Current laser application in En bloc resection of bladder tumor- a narrative literature review.

作者信息

Gao Wenbo

机构信息

Department of Urology, Ningbo Urology and Nephrology Hospital, N0. 999, Road Qianhe, Ningbo City, Zhejiang Province, 315100, China.

出版信息

World J Surg Oncol. 2025 Apr 26;23(1):165. doi: 10.1186/s12957-025-03815-0.

DOI:10.1186/s12957-025-03815-0
PMID:40287765
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12034164/
Abstract

At present, laser en bloc resection of bladder tumor (ERBT) has attracted great interest with potential superiority to transurethral resection of bladder tumor (TURBT). It has several advantages, including complete resection, intact specimen for accurate histologic assessment, avoiding fragmentation and tumor seeding, preventing obturator nerve reflex, and reduction of inflammatory response. Several types of lasers have been studied in the application of ERBT, for example, holmium laser, green-light laser, thulium laser, diode laser. This paper reviews current literature concerning the characteristics of these types of laser, the surgical technique and procedures of laser ERBT with its advantages and limitations, and future directions in clinical development, aiming to display the status quo of these techniques in clinical practice.

摘要

目前，膀胱肿瘤整块激光切除术（ERBT）已引起广泛关注，相较于经尿道膀胱肿瘤切除术（TURBT）具有潜在优势。它具有多种优点，包括完整切除、获得完整标本以进行准确的组织学评估、避免肿瘤破碎和播散、防止闭孔神经反射以及减轻炎症反应。已有多种类型的激光应用于ERBT的研究，例如钬激光、绿光激光、铥激光、二极管激光。本文综述了有关这些类型激光的特性、激光ERBT的手术技术和操作及其优缺点以及临床发展的未来方向的当前文献，旨在展示这些技术在临床实践中的现状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dae/12034164/4245bf16eb2a/12957_2025_3815_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dae/12034164/7ab160bcad3e/12957_2025_3815_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dae/12034164/9e586d425f55/12957_2025_3815_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dae/12034164/4245bf16eb2a/12957_2025_3815_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dae/12034164/7ab160bcad3e/12957_2025_3815_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dae/12034164/9e586d425f55/12957_2025_3815_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dae/12034164/4245bf16eb2a/12957_2025_3815_Fig3_HTML.jpg

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本文引用的文献

1
Current opinions regarding the clinical utility of en bloc resection in the treatment of non-muscle invasive bladder cancer-a review of the literature.关于整块切除在非肌层浸润性膀胱癌治疗中的临床应用的当前观点——文献综述
Discov Oncol. 2024 Oct 19;15(1):574. doi: 10.1007/s12672-024-01452-9.
2
En-bloc resection of non-muscle invasive urinary bladder tumors using low power Holmium laser-A new promise.使用低功率钬激光整块切除非肌层浸润性膀胱肿瘤——一项新希望
Urologia. 2025 Feb;92(1):39-43. doi: 10.1177/03915603241277914. Epub 2024 Sep 4.
3
Prospective non-randomized comparison of transurethral laser en bloc resection vs. conventional resection of bladder tumors larger than 3 cm.
经尿道激光整块切除术与传统切除术治疗大于 3cm 的膀胱肿瘤的前瞻性非随机比较。
Minerva Urol Nephrol. 2024 Aug;76(4):436-441. doi: 10.23736/S2724-6051.24.05682-9.
4
A novel laser resection approach: efficacy of rotatable bi-channel en bloc resection of bladder tumor in a pilot in-vivo study.一种新型的激光切除方法：在体内初步研究中，旋转双通道整块切除膀胱肿瘤的疗效。
Lasers Med Sci. 2024 Jul 22;39(1):188. doi: 10.1007/s10103-024-04147-3.
5
Experts' recommendations in laser use for the treatment of bladder cancer: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training and Research in Urological Surgery and Technology (TRUST)-Group.专家关于膀胱癌激光治疗应用的建议：欧洲泌尿技术协会（ESUT）和泌尿外科手术与技术培训和研究（TRUST）组的综合指南。
World J Urol. 2024 Feb 14;42(1):79. doi: 10.1007/s00345-024-04786-9.
6
Transurethral Resection of Bladder Tumor: Novel Techniques in a New Era.经尿道膀胱肿瘤切除术：新时代的新技术。
Bladder (San Franc). 2023 Nov 9;10:e21200009. doi: 10.14440/bladder.2023.865. eCollection 2023.
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High-power green-light laser endoscopic submucosal dissection for non-muscle-invasive bladder cancer: A technical improvement and its initial application.高能绿光激光内镜黏膜下剥离术治疗非肌层浸润性膀胱癌：技术改进及初步应用。
J Cancer Res Ther. 2023 Aug;19(4):945-950. doi: 10.4103/jcrt.jcrt_674_22.
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Current Techniques for En Bloc Transurethral Resection of Bladder Tumor: A Hands-on Guide Through the Energy Landscape.当前整块经尿道膀胱肿瘤切除术的技术：能量景观中的实践指南。
Eur Urol Focus. 2023 Jul;9(4):567-570. doi: 10.1016/j.euf.2023.04.007. Epub 2023 May 11.