Thulium-laser retrograde intra renal ablation of upper urinary tract transitional cell carcinoma: an ESUT Study

Bozzini, Giorgio; Gastaldi, C.; Besana, Umberto; Calori, Alberto; Casellato, Stefano; Parma, P.; Pastore, Antonio Luigi; Macchi, Alberto; Breda, Alberto; Gözen, A.S.; Skolarikos, Andreas; Herrmann, Thomas; Scoffone, Cesare Marco; Eissa, Ahmed; Sighinolfi, Maria Chiara; Rocco, B.; Buizza, Carlo; Liatsikos, Evangelos

doi:10.23736/s2724-6051.20.03689-9

Cited by 27 publications

(31 citation statements)

References 37 publications

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“…A recent ESUT (EAU Section of Uro-Technology) retrospective observational multicentric study reported similar oncological outcomes (19.2% recurrence) with no ureteral strictures in 47 patients treated conservatively with TL laser for low risk tumors. 39 Drawbacks of Thulium laser are related to necrotic tissue adhering to the fiber tip, requiring multiple entries through the access sheath. For these reasons recent studies are evaluating a combined ablation technique, mostly in larger tumors: it starts with the Thulium until the targeted tissue is fully necrotized on the surface (this step avoids the bleeding that usually occurs with the holmium), it is completed with the holmium in order to remove the necrotic layer and to show up the eventual residual tumor tissue that needs to be ablated or vessels to be coagulated by Thulium again.…”

Section: Upper Tract Urothelial Carcinomamentioning

confidence: 99%

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RETRACTED: Laser technology in urologic oncology

et al. 2022

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Laser technology has been used in Urology since the 80s with a lot of different applications in endoscopic and open surgery. With the developments of the technology and the introduction of new active medium and source of laser energy, this technology have become the gold standard not only in stone surgery but even in benign prostate enlargement (BPE) surgical treatment. Regarding urologic oncology, laser energy has now reached an important role in focal therapy and in conservative treatment. The possibility of having better functional outcomes without any relevant impact on oncological results led to an increased use of laser in penile surgery, with a significant mention in urological guidelines for this option. In urothelial cancers as well, both in conservative management of upper tract tumors that in the treatment of non muscle invasive bladder cancer, a clear role of these relatively new source of energy have been demonstrated. Finally, both in prostate that in renal cancer the strategy of focal therapy may take advantage from this precise and fine technology. In this review we analyzed and described the applications of laser energy in urological cancers with a specific focus on penile, urothelial and prostate cancer.

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Section: Upper Tract Urothelial Carcinomamentioning

confidence: 99%

Section: Upper Tract Urothelial Carcinomamentioning

confidence: 99%

RETRACTED: Laser technology in urologic oncology

et al. 2022

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“…Thu:YAG provides a continuous wave and a lower tissue penetration resulting in good vaporisation and coagulation properties for treating soft tissue disease, though it does appear to cause more tissue necrosis [33]. Four studies included in our review used Thu:YAG, two in combination with Ho:YAG and two in isolation [14,21,24,25].…”

Section: Modality Of Laser Ablation and Emerging Technologiesmentioning

confidence: 99%

“…The included studies using Ho:YAG or Nd:YAG showed progression to NU in 16.6-35.9% vs 8.9-13.5% in studies using Thu:YAG and upper tract recurrence 24.6-90.5% vs. 19.2-49% for Thu:YAG [14,21,24,25]. Defidio et al (2011) reported the comparative outcomes of Thu:YAG and Ho:YAG in a multicentre European study.…”

Section: Modality Of Laser Ablation and Emerging Technologiesmentioning

confidence: 99%

Role of Ureteroscopy in Treatment of Upper Tract Urothelial Carcinoma

et al. 2021

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Purpose of Review Upper tract urothelial carcinoma (UTUC) is uncommon accounting for less than 10% of all urothelial tumours. Ureteroscopic management (URS) is the first line treatment for low-risk disease and has been increasingly utilised due to technological advances and increasing surgical experience. This review looks at patient outcomes relating to URS, emerging technologies and the role of adjuvant intracavitary therapy in the management of UTUC. Recent Findings URS has firmly established itself in the management algorithm for UTUC, and a good body of evidence supports its use for low-risk disease, wherein oncological outcomes are comparable to traditional nephroureterectomy (RNU). Larger tumours can now be managed using URS with a lower morbidity than radical surgery, though with higher associated local recurrence rate and risk of progression to RNU, and as a result, patient selection and close surveillance remains key. There is limited evidence for adjuvant intracavitary therapy (Mitomycin C or BCG) in UTUC although the development of novel polymers and biodegradable stents may improve drug delivery to the upper urinary tract. Summary URS has a clearly defined role in low-risk UTUC, and its use in larger tumours appears to be appropriate in a selected cohort of patients. The efficacy of adjuvant intracavitary therapy is as of yet undetermined, though developments in delivery techniques are promising. Likewise further developments of laser technology are anticipated to further expand the role of URS.

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“…According to the American and European Associations of Urology guidelines (AUA, EAU), radical nephroureterectomy (RNU) represents the standard of care for localized UTUC [2] with recent trends indicating an increasing predilection for minimally invasive surgical approaches (MIS) when compared with traditional open radical nephroureterectomy (ORNU). Laparoscopic (LNU) and robotassisted nephroureterectomy (RANU) have similar oncological outcomes with the benefit of shorter postoperative recovery [3][4][5][6][7]. Also, level 1 evidence confirms that a single postoperative dose of intravesical chemotherapy (PIC), 2-10 days after surgery should be administered to reduce the risk of bladder tumor recurrence [8][9].…”

Section: Introductionmentioning

confidence: 99%