A Randomized Controlled Trial on Holmium Laser Resection and Plasmakinetic Resection of Bladder Tumors_West China Medical Journal

Authors：

 HUANGZhong-li , LIHong , WEIQiang , WANGKun-jie , DONGQiang , LIXiang , SHIMing

Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

Bladder tumor; Holmium laser; Plasmakinetic resection

DOI：

10.7507/1002-0179.20150539

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Objective To compare the clinical efficacy of transurethral plasmakinetic resection of bladder tumors (PKRBT) and holmium laser resection of bladder tumors (HOLBT), and discuss the effcacy, safety, indication, and complications of PKRBT for the treatment of bladder tumors compared with HOLBT. Methods A hundred patients with bladder tumors were divided into two groups randomly, who were selected from patients in the Department of Urology of West China Hospital from March 2011 to March 2013. Among all the 100 cases, half of them were treated with PKRBT, and all others treated with HOBLT. The significant markers in both groups were recorded and evaluated, including the situation of before operation, during operation and after operation. The data recorded consisted of the general records of patients' medical background, concomitant disease, laboratory examination, and the position, amount, pathology of the tumor, total operative duration, the time of gross hematuria, the time of postoperative bladder irrigation and catheterization, the length of stay, postoperative complications and patients' conditions at month 3, 6, and 12 during the follow-up. Results All operations were successfully performed, and there was no significant diTherences between the two groups in preoperative indexes (P>0.05). No abnormalities were detected in the postoperative laboratory examinations. The diTherences in operatative duration, time of bladder irrigation, duration of indwelling catheter, and postoperative length of stay between the two groups were not significant (P>0.05). But the mean time of gross hematuria was significantly shorter after operation in the HOLBT patients [(6.1±7.6) hours] than in those treated with PKRBT [(15.3±17.2) hours] (P<0.05). There was no significant diTherence between the two groups in the recurrence rate 3, 6, and 12 months after operation (P>0.05). Conclusion HOLBT can be used safely and effectively in treating bladder tumors, and it is easy for clinical manipulation. HOLBT is as effective and safe as PKRBT with similar adverse side-effect rate within and after operation.

Citation： HUANGZhong-li, LIHong, WEIQiang, WANGKun-jie, DONGQiang, LIXiang, SHIMing. A Randomized Controlled Trial on Holmium Laser Resection and Plasmakinetic Resection of Bladder Tumors. West China Medical Journal, 2015, 30(10): 1877-1880. doi: 10.7507/1002-0179.20150539 Copy

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2.	陈伟, 薄隽杰, 张连华, 等. 经尿道钬激光治疗浅表性膀胱肿瘤的临床分析——附92例报告[J]. 中国癌症杂志, 2009, 19(3):214-217.
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4.	Fleshner NE, Herr HW, Stewart AK, et al. The National cancer data base report on bladder carcinoma[J]. Cancer, 1996, 78(7): 1505-1513.
5.	Ro JY, Staerkel GA, Ayala AG. Cytologic and histologic features of superficial bladder cancer[J]. Urol Clin North Am, 1992, 19(3): 435-553.
6.	Herrmann TR, Liatsikos EN, Nagele U, et al. EAU guidelines on laser technologies[J]. Eur Urol, 2012, 61(4):783-795.
7.	Kramer MW, Bach T, Wolters M, et al. Current evidence for transurethral laser therapy of non-muscle invasive bladder cancer[J]. W J Urol, 2011, 29(4):433-442.
8.	Alschibaja M, May F, Treiber U, et al. Recent improvements in transurethral high-frequency electrosurgery of the prostate[J]. BJU Int, 2006, 97(2):243-246.
9.	Teichman JM, Glickman RD, Chan KF, et al. Plasma bubble formation induced by holmium laser[J]. Urology, 2005, 65(3): 627-628.
10.	Babjuk M, Burger M, Zigeuner R, et al. EAU guidelines on nonmuscle-invasive urothelial carcinoma of the bladder:update 2013[J]. Eur Urol, 2013, 64(4):639-653.
11.	Aho TF, Gilling PJ. Current techniques for laser prostatectomy—— PVP and HoLEP[J]. Arch Esp Urol, 2008, 61(9):1005-1013.
12.	Zhu YF, Jiang XZ, Zhang JP, et al. Safety and effcacy of holmium laser resection for primary nonmuscle-invasive bladder cancer versus transurethral electroresection:single-center experience[J]. Urology, 2008, 72(3):608-612.
13.	Takahashi T, Kakehi Y, Mitsumori K, et al. Distinct microsatellite alterations in upper urinary tract tumors and subsequent bladder tumors[J]. J Urol, 2001, 165(2):672-677.
14.	Syed HA, Talbot N, Abbas A. Flexible cystoscopy and holmium: yttrium aluminum garnet laser ablation for recurrent nonmuscle invasive bladder carcinoma under local anesthesia[J]. J Endourol, 2013, 29(2):231-234.
15.	孙颖浩, 许传亮, 温晓飞, 等. 钬激光联合膀胱灌注治疗浅表性膀胱肿瘤(附30例报告)[J]. 中华泌尿外科杂志, 2003, 24(6):19-21.
16.	Yamada Y, Honda N, Nakamura K, et al. Clinical experience of ureteroscopic treatment for ureteral transitional cell carcinoma using the holmium:YAG laser[J]. Oncol Rep, 2003, 10(4):821-825.

1. 张薇, 项永兵, 刘振伟, 等. 1973-1999年上海市区老年人恶性肿瘤发病趋势分析[J]. 中华老年医学杂志, 2005, 24(9):701-704.
2. 陈伟, 薄隽杰, 张连华, 等. 经尿道钬激光治疗浅表性膀胱肿瘤的临床分析——附92例报告[J]. 中国癌症杂志, 2009, 19(3):214-217.
3. Kirkali Z, Chan T, ManoharanM, et al. Bladdercancer:epidemiology, staging and grading, anddiagnose[J]. Urology, 2005, 66(Suppl 6A): 4-34.
4. Fleshner NE, Herr HW, Stewart AK, et al. The National cancer data base report on bladder carcinoma[J]. Cancer, 1996, 78(7): 1505-1513.
5. Ro JY, Staerkel GA, Ayala AG. Cytologic and histologic features of superficial bladder cancer[J]. Urol Clin North Am, 1992, 19(3): 435-553.
6. Herrmann TR, Liatsikos EN, Nagele U, et al. EAU guidelines on laser technologies[J]. Eur Urol, 2012, 61(4):783-795.
7. Kramer MW, Bach T, Wolters M, et al. Current evidence for transurethral laser therapy of non-muscle invasive bladder cancer[J]. W J Urol, 2011, 29(4):433-442.
8. Alschibaja M, May F, Treiber U, et al. Recent improvements in transurethral high-frequency electrosurgery of the prostate[J]. BJU Int, 2006, 97(2):243-246.
9. Teichman JM, Glickman RD, Chan KF, et al. Plasma bubble formation induced by holmium laser[J]. Urology, 2005, 65(3): 627-628.
10. Babjuk M, Burger M, Zigeuner R, et al. EAU guidelines on nonmuscle-invasive urothelial carcinoma of the bladder:update 2013[J]. Eur Urol, 2013, 64(4):639-653.
11. Aho TF, Gilling PJ. Current techniques for laser prostatectomy—— PVP and HoLEP[J]. Arch Esp Urol, 2008, 61(9):1005-1013.
12. Zhu YF, Jiang XZ, Zhang JP, et al. Safety and effcacy of holmium laser resection for primary nonmuscle-invasive bladder cancer versus transurethral electroresection:single-center experience[J]. Urology, 2008, 72(3):608-612.
13. Takahashi T, Kakehi Y, Mitsumori K, et al. Distinct microsatellite alterations in upper urinary tract tumors and subsequent bladder tumors[J]. J Urol, 2001, 165(2):672-677.
14. Syed HA, Talbot N, Abbas A. Flexible cystoscopy and holmium: yttrium aluminum garnet laser ablation for recurrent nonmuscle invasive bladder carcinoma under local anesthesia[J]. J Endourol, 2013, 29(2):231-234.
15. 孙颖浩, 许传亮, 温晓飞, 等. 钬激光联合膀胱灌注治疗浅表性膀胱肿瘤(附30例报告)[J]. 中华泌尿外科杂志, 2003, 24(6):19-21.
16. Yamada Y, Honda N, Nakamura K, et al. Clinical experience of ureteroscopic treatment for ureteral transitional cell carcinoma using the holmium:YAG laser[J]. Oncol Rep, 2003, 10(4):821-825.

West China Medical Journal

A Randomized Controlled Trial on Holmium Laser Resection and Plasmakinetic Resection of Bladder Tumors

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