The eﬃcacy and safety of thulium laser resection of bladder tumor versus standard transurethral resection in patients with non-muscle-invasive bladder cancer: a systematic review and meta-analysis
1Department of Urology, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, P. R. China
2Department of Urology, The Aﬃliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 266101 Shandong, P. R. China
3Department of Urology, PLA Rocket Force Characteristic Medical Center, 100088 Beijing, P. R. China
DOI: 10.31083/jomh.2021.023 Vol.17,Issue 2,April 2021 pp.32-42
Published: 08 April 2021
† These authors contributed equally.
Purpose: This study was to analyze the eﬃcacy and safety of thulium laser resection of bladder tumor (Tm-TURBT) versus TURBT for patients with non-muscle-invasive bladder cancer (NMIBC).
Materials and Methods: Randomized controlled trial data were retrieved using the MEDLINE, Embase, Web of Science, and the Cochrane Library. We also searched Chinese databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang data and VIP data.
Results: A total of sixteen articles including 1662 participants were enrolled into our meta-analysis. We found no signiﬁcant difference in terms of operation time, urethral stricture, 1-year recurrence rate, overall 1-year recurrence rate and overall 3-year recurrence rate between the two groups. Less intraoperative blood loss and a lower incidence of obturator nerve reﬂex (ONR), bladder perforation and bladder irritation were identiﬁed in Tm-TURBT group than in TURBT group in our analysis. The analysis also demonstrated faster postoperative recovery in terms of the catheterization, bladder irrigation and hospitalization time in Tm-TURBT group. The subgroup analysis was conducted based on different postoperative chemotherapy (epirubicin and non-epirubicin) concerning recurrence rate whereas no signiﬁcant difference was noted.
Conclusion: Tm-TURBT is an eﬃcient and safe treatment for NMIBC and it could be an alternative choice for TURBT. Given that some limitations are clearly identiﬁed, more large-scale and well-designed RCTs are needed to conﬁrm our ﬁndings.
Transurethral resection of bladder tumor; Bladder tumor; Thulium laser; Meta-analysis; Randomized controlled trials
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