Novel Green-Light KTP Laser <i>En Bloc</i> Enucleation for Nonmuscle-Invasive Bladder Cancer: Technique and Initial Clinical Experience

He, Dalin; Fan, Jinhai; Wu, Kaijie; Wang, Xinyang; Wu, Dapeng; Li, Lei; Li, Xudong; Liu, Lixia; Cao, Peilong; Cao, Jun; Chang, Luke S.

doi:10.1089/end.2013.0740

Cited by 40 publications

(30 citation statements)

References 21 publications

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“…Urol Int 2020;104:402-409 DOI: 10.1159/000503734 high as 97% [26] and 100% [27,28]. These studies emphasize the quality of NMIBC resection can be improved with ERBT.…”

mentioning

confidence: 85%

Is the En Bloc Transurethral Resection More Effective than Conventional Transurethral Resection for Non-Muscle-Invasive Bladder Cancer? A Systematic Review and Meta-Analysis

et al. 2020

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Background: En bloc transurethral resection (ERBT) is a major topic of discussion as an alternative to conventional transurethral resection (cTURBT) for the treatment of nonmuscle-invasive bladder cancer (NMIBC) addressing the limitations of cTURBT. Methods: We searched through electronic databases including Embase, Cochrane Library, MEDLINE, Web of Science, PubMed, and Google Scholar for articles published up to April 1, 2019; RevMan 5.3 was used to conduct this meta-analysis. Results were expressed as 95% confidence intervals (CI) and risk differences (RD). Results: Nine trials met the inclusion criteria (n = 1,020 patients): 1 study was a randomized controlled trial including a total of 142 participants, 4 studies had a prospective paired design including 605 patients, and 4 studies were retrospective (n = 273 patients). Duration of continuous postoperative bladder irrigation (RD -0.16; 95% CI -3.47 to 0.28; I 2 = 97%; p = 0.10) and operation time (RD 0.05; 95% CI -0.23 to 0.32; I 2 = 79%; p = 0.74) were not significantly different between ERBT and cTURBT. However, hospitalization time (I 2 = 96%; χ 2 = 203.16; p = 0.01) and catheterization time (I 2 = 95%; χ 2 = 163.24; p = 0.02), as well as 24-month recurrence rate (I 2 = 0%; χ 2 = 0.98; p = 0.008) were significantly better using the ERBT scheme. The incidence of urethral stricture between both schemes (95% CI -0.03 to 0.02; p = 0.50) was not different, but complications such as obturator nerve reflex (95% CI 0.01 to 0.12; p < 0.00001) and bladder perforation (95% CI 0.05 to 0.59; p = 0.50) were less frequent in the ERBT group. Conclusion: ERBT is an effective treatment approach with some advantages for NMIBC. Our meta-analysis revealed that hospitalization time, catheterization time, and 24-month recurrence rate is superior in patients treated with ERBT than cTURBT, and ERBT patients also have a lower complication rate. Furthermore, ERBT improves the quality of tumor specimens and decreases the frequency of repeat transurethral bladder cancer resection. Further randomized controlled trials are needed to confirm our results.

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“…Urol Int 2020;104:402-409 DOI: 10.1159/000503734 high as 97% [26] and 100% [27,28]. These studies emphasize the quality of NMIBC resection can be improved with ERBT.…”

mentioning

confidence: 85%

Is the En Bloc Transurethral Resection More Effective than Conventional Transurethral Resection for Non-Muscle-Invasive Bladder Cancer? A Systematic Review and Meta-Analysis

et al. 2020

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“…Yet, the main disadvantage was the lack of sufficient tissue for pathologic examination [63]. Subsequently, He et al introduced en bloc with a KTP laser using front-firing fibre on 45 patients, showing the feasibility and safety of the procedure [64]. In the prospective, non-randomised study on 158 patients (83 KTP en-bloc and 75 cTURBT) by Chen et al the authors showed that resection with laser was associated with lower complication rates and had shorter duration.…”

Section: En Bloc Using a Green-light Ktp Lasermentioning

confidence: 99%

Technical developments in transurethral resection of bladder tumours

Pastuszak

Zdrojowy

Poletajew

et al. 2019

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Bladder cancer is one of the most common malignancies worldwide. The transurethral resection of bladder tumour (TURB) remains the gold standard in both diagnostics and treatment. Because of the importance of TURB in bladder cancer management and the fact that TURB is one of the most commonly performed urologic procedures, it is the subject of continuous technological development. The latest advances in the field of endourology are aimed at increasing surgical accuracy and thus reducing the risk of bladder tumour recurrence and progression. However, despite the constant progress in technology and technique, there are still a lack of good quality data showing the superiority of any of the methods. The aim of this paper is to present available data on new technological developments in surgical technique of TURB. Advantages and disadvantages of currently available methods are discussed, and literature showing their effectiveness and safety is shown.

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“…Bei den Kalium-Titanyl-Phosphat-und Lithiumborat-Lasern (KTP, LBO; besser bekannt als Greenlight-Laser) basierten Ansätzen, vor allem ohne side fire-Faser, ist bei der Anwendung darauf zu achten, keine unkontrollierten und ungewollten Gewebsschäden außerhalb des Resektionsareals zu verursachen, da Laserenergie auf dieser Wellenlänge von 532 nm nicht durch das Spülmedium abgebremst wird [33]. Für die KTP/LBO-Laser wurden Energieleistungen von 30 [34]…”

Section: Die Laser-erbt (L-erbt)unclassified

Die En bloc-Resektion von Blasentumoren (ERBT) – eine Bestandsaufnahme

et al. 2017

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Limitations inherent in the conventional transurethral resection of bladder tumours, the standard approach for diagnosis and treatment of bladder cancer, are well known: staging errors due to insufficient resection depth as well as intravesical tumour fragmentation, both of which make histopathological evaluation difficult. The purpose of this review is to present recent clinical data on the en-bloc resection of bladder tumours (ERBT), which has been demonstrated to offer a high potential to overcome these limitations. The recent findings show that ERBT provides a good resection quality with varying detection rates for tunica muscularis, which is a surrogate marker for resection quality regarding muscle-invasive tumours. ERBT can be performed using all energy sources. Available data show no relevant difference with regard to perioperative morbidity compared with cTURB. No conclusions can be drawn regarding the impact of ERBT on recurrence as the data are partly controversial. This has to be defined by further studies.

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Novel Green-Light KTP Laser En Bloc Enucleation for Nonmuscle-Invasive Bladder Cancer: Technique and Initial Clinical Experience

Cited by 40 publications

References 21 publications

Is the En Bloc Transurethral Resection More Effective than Conventional Transurethral Resection for Non-Muscle-Invasive Bladder Cancer? A Systematic Review and Meta-Analysis

Is the En Bloc Transurethral Resection More Effective than Conventional Transurethral Resection for Non-Muscle-Invasive Bladder Cancer? A Systematic Review and Meta-Analysis

Technical developments in transurethral resection of bladder tumours

Die En bloc-Resektion von Blasentumoren (ERBT) – eine Bestandsaufnahme

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