Article Sidebar
Views PDF: 1
EARLY RESULTS OF TRANSURETHRAL ENDOSCOPIC EN-BLOC RESECTION OF TUMOR USING HOLMIUM LASER IN THE TREATMENT OF NON-MUSCLE-INVASIVE BLADDER CANCER COMBINED WITH INTRAVESICAL GEMCITABINE INSTILLATION
Main Article Content
Abstract
Objectives: To evaluate the efficacy and safety of transurethral en-bloc resection of bladder tumors using holmium laser (HolERBT) combined with intravesical Gemcitabine instillation in the treatment of non-muscle-invasive bladder cancer (NMIBC). Methods: A prospective case series study was conducted on 21 patients with NMIBC who underwent HolERBT from January 2024 to March 2025. All patients received intravesical chemotherapy with Gemcitabine 2,000mg per instillation for 6 weeks, from 10 to 14 days after surgery. Results: Male patients accounted for 76.2%, female patients accounted for 23.8%. The mean age was 62.52 ± 14.073 years. Preoperative CT-scan (21/21 cases) detected bladder tumor in 95.2% (20/21 cases), no bladder tumor in 4.8% (1/21 cases). Mean tumor size: 13.8 ± 7.18 mm. The detrusor muscle was obtained in 20/21 cases (95.2%). The mean operative time was 33.43 ± 12.56 minutes. The mean duration of postoperative catheterization was 1.62 ± 0.59 days. Postoperative pathology: Low-grade papillary urothelial carcinoma was 8/21 cases (38.1%), high-grade papillary urothelial carcinoma was 13/21 cases (61.9%); stage pTa: 42.9%, pT1: 57.1%. There were no intraoperative complications. No cases of obturator nerve reflex were observed. Recurrence occurred in 1 case (4.8%) after 9 months. Conclusion: HolERBT in the treatment of NMIBC is safe and feasible.
Article Details
Keywords
Bladder tumor, En-bloc, Holmium Laser, Gemcitabine
References
2. Teoh JY, Kamat AM, Black PC, et al. Recurrence mechanisms of non-muscle-invasive bladder cancer - a clinical perspective. Nat. Rev. Urol. 2022; 19:280-294.
3. Nguyễn Phúc Cẩm Hoàng, Nguyễn Thanh Mộng, Trần Trọng Huân. Ưu điểm của phương pháp cắt đốt nội soi lấy nguyên khối bướu BQ bằng điện lưỡng cực. Tạp chí Y học Thành phố Hồ Chí Minh. 2021; 25(1):195-199.
4. Abdelwahab Hashem, Ahmed Mosbah, Nasr A El-Tabey et al. Holmium laser en-bloc resection versus conventional transurethral resection of bladder tumors for treatment of non-muscle-invasive bladder cancer: A randomized clinical trial. Eur Urol Focus. 2021; 7:1035-1043.
5. Campi R, Seisen T, Roupret M. Unmet clinical needs and future perspectives in non-muscle-invasive bladder cancer. Eur Urol Focus. 2018; 4:472-480.
6. Marko Babjuk, Maximilian Burger, Otakar Capoun et al. European Association of Urology Guidelines on non–muscleinvasive bladder cancer (Ta, T1, and Carcinoma in Situ). Eur Urol. 2022; 81(1):75-94.
7. Kramer MW, Rassweiler JJ, Klein J et al. En bloc resection of urothelium carcinoma of the bladder (EBRUC): A European multicenter study to compare safety, efficacy, and outcome of laser and electrical en bloc transurethral resection of bladder tumor. World J Urol. 2015; 33:1937-1943.
8. Dong Ha Kim, Taek Sang Kim, Su Hwan Kang, Seong Bin Kim. Efficacy of intravesical gemcitabine instillation compared with intravesical Bacillus Calmette-Guérin instillation for non-muscle invasive bladder cancer. Kosin Medical Journal. 2024; 39(4):254-258.