Evaluation of the clinical effectiveness of transurethral bipolar surgery and laser technologies in treatment of patients with non-muscle-invasive bladder cancer

Abstract

BACKGROUND: Bladder cancer is the most common urinary tract cancer. Transurethral resection of the bladder wall tumor is the gold standard for non-muscle-invasive bladder cancer. In recent years, laser technologies have been actively implemented into clinical practice, including the surgical treatment of bladder cancer, but there are still many questions regarding their use.

AIM: To evaluate the efficacy and safety of bladder wall tumor resection followed by neodymium (Nd:YAG) laser ablation of the tumor.

MATERIALS AND METHODS: Surgical treatment outcomes in 97 patients with non-muscle-invasive bladder cancer were analyzed for the period between 2012 and 2023. Group 1 (n = 49) underwent classical transurethral resection of the bladder wall. Group 2 (n = 47) underwent the same procedure followed by Nd:YAG laser ablation of the tumor bed. Treatment outcomes were evaluated at 3, 6, and 12 months after surgery.

RESULTS: Analysis of complications using the Clavien–Dindo classification system showed a more favorable postoperative course in group 2. Within 1 year after surgery, the rate of bladder cancer recurrence was significantly lower in group 2 compared to group 1, with 4 and 13 cases, respectively (p < 0.05). In addition, no patient in group 2 had a recurrence in the area of the resected tumor bed, whereas 9 patients in group 1 had such recurrence during the specified period.

CONCLUSIONS: The study demonstrates the potential of using laser technologies in the treatment of bladder cancer. Its clinical implementation will facilitate personalized surgical treatment options for patients with urological cancers and reduce the risk of tumor recurrence.

Keywords

bladder cancer / non-muscle-invasive bladder cancer / transurethral resection of the bladder wall tumor / neodymium laser / Nd:YAG laser ablation

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