Safety and Efficacy of En Bloc Transurethral Resection With 1.9 µm Vela Laser for Treatment of Non–Muscle-invasive Bladder Cancer

Xu, Hao; Ma, Jun; Chen, Zhong; Yang, Jun; Yuan, Huixin; Wang, Tao; Liu, Jihong; Ye, Weimin; Ye, Zhangqun

doi:10.1016/j.urology.2017.11.030

Cited by 41 publications

(55 citation statements)

References 16 publications

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“…A flowchart of the screening procedure is shown in Figure 1. Tables 1 and 2 show the clinical characteristics of the 1,020 patients included in the 9 studies meeting the inclusion criteria [9][10][11][12][13][14][15][16]. One study was an RCT with a total of 142 participants.…”

Section: Study Selectionmentioning

confidence: 99%

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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Section: Study Selectionmentioning

confidence: 99%

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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“…Recurrence rates at 12 months were reported in 7 articles [16, 24, 27, 28, 31-33] and recurrence rates at 24 months were reported in 8 articles [15, 25, 29-34]. A meta-analysis of fixed-effect models showed that the recurrence rates of transurethral laser surgery at 12 months (OR = 0.66; 95% CI 0.48–0.9; p = 0.008) (Fig.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Transurethral Laser Surgery Versus Transurethral Resection for Non-Muscle-Invasive Bladder Cancer: A Meta-Analysis and Systematic Review

Wang

Ouyang

et al. 2020

Urol Int

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Objective: To compare the efficacy and safety of transurethral laser surgery and transurethral resection of a bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC). Material and Methods: A research was carried out in Medline via PubMed, EMBASE, the Cochrane Library, and Web of Science up to October 20, 2019, to identify articles related to transurethral laser surgery and TURBT for NMIBC. All analyses were done using RevMan5.3 and Stata14. Results: A total of 17 studies involving 2,439 participants were included. The analysis showed no significant difference in operation times (mean difference =-0.2; 95% CI-2.29 to 1.89; p = 0.85) or occurrences of urethral stricture (OR = 0.7; 95% CI 0.24-2.06; p = 0.52). Transurethral laser surgery was associated with a lower incidence of obturator nerve reflex (OR = 0.04; 95% CI 0.02-0.09; p < 0.00001) and bladder perforation (OR = 0.09; 95% CI 0.04-0.23; p < 0.00001), a higher rate of detrusor muscle acquisition (OR = 5.28; 95% CI 2.42-11.49; p < 0.0001), shorter catheterization (mean difference =-1.05; 95% CI-1.41 to-0.68; p < 0.00001) and hospitalization times (mean difference =-0.96; 95% CI-1.59 to-0.33; p = 0.003), and lower rates of bladder irrigation (OR = 0.21; 95% CI 0.13-0.35; p < 0.00001) and recurrence both at 12 months (OR = 0.66; 95% CI 0.48-0.9, p = 0.008) and at 24 months (OR = 0.6; 95% CI 0.41-0.86; p = 0.005). Conclusions: Transurethral laser surgery for NMIBC, as compared to TURBT, is associated with a lower incidence of complications, a lower recurrence rate, and faster postoperative recovery.

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“…In addition, laser en bloc resection reduces the risk of scattered tumour cells during surgery [16]. The safety and e cacy of lasers including thulium laser, holmium laser, 2 µm laser and 1.9 µm vela laser have been veri ed in clinical practice [17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Preliminary Experience of 980nm Diode Laser Treatment for Non-Muscle-Invasive Bladder Tumor with En bloc Technique

Mao¹,

Zhang²,

Cui³

et al. 2020

Preprint

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BackgroundThe disease addiction to chemical substances or drugs such as alcohol (ethanol, C2H5OH) is still not recognised by many medical practitioners as a diagnostic nosology in Ghana. It is usually considered a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUDs).MethodA qualitative approach of in-depth interviews and observations which described the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of ten private and public hospitals in the Greater-Accra Metropolis was adopted. The face-to face interviews conducted using a an interview guide were audio-recorded and later transcribed. On average, the interview lasted between 45 and 60 minutes.ResultsFindings from the 10 interviews revealed that psychological factors accounted for AUD regardless of the nature of their work. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no employee assistance programmes (EAPs) and the few that had some policies on AUD were not implementing them.ConclusionThis paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their mental well-being which is AUD. However, there are other pertinent issues that are crucial to employee total well-being that can be addressed in future research.

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Safety and Efficacy of En Bloc Transurethral Resection With 1.9 µm Vela Laser for Treatment of Non–Muscle-invasive Bladder Cancer

Cited by 41 publications

References 16 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

Efficacy and Safety of Transurethral Laser Surgery Versus Transurethral Resection for Non-Muscle-Invasive Bladder Cancer: A Meta-Analysis and Systematic Review

Preliminary Experience of 980nm Diode Laser Treatment for Non-Muscle-Invasive Bladder Tumor with En bloc Technique

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