Comparative study of thulium and holmium laser in non-muscle invasive bladder cancer

Popov S.V., Guseinov R.G., Pomeshkin E.V., Skryabin O.N., Sivak K.V., Perepelitsa V.V., Lelyavina T.A., Malyshev E.A.

1) Saint Petersburg GBUZ «City Hospital Saint Luka», Saint Petersburg, Russia; 2) FGBVOU VO S.M. Kirov Military Medical Academy of the Ministry of Defense of Russian Federation, Moscow, Russia; 3) FGBOU VO Saint Petersburg State University, Saint Petersburg, Russia; 4) FGBU A.A. Smorodintsev Research Institute of Influenza of the Ministry of Health of Russia, Saint Petersburg, Russia; 5) FGBU National Medical Research Center named after V.A. Almazov of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia

Aim. To compare thulium and holmium lasers in the treatment of non-muscle invasive bladder cancer (NMIBC). Materials and methods. In our work, patients were divided into 3 groups, depending on the treatment method. In the group 1 (n=27, 32.14% of the cohort), thulium laser resection of the bladder was done, while in the group 2 (n=25, 29.76% of the cohort) and group 3 (n=32, 38.10 % of the cohort) holmium laser resection and standard transurethral resection (TUR) were performed, respectively. In the preoperative period, all patients underwent a standard clinical examinations and imaging studies (computed tomography of the thorax, abdomen and retroperitoneal space, magnetic resonance imaging of the pelvis, cystoscopy, cytological examination of urine sediment). Results. The duration of the procedure was 14.7±5.2 minutes for a thulium laser and 16.3±5.3 minutes for a holmium laser, compared to 20.5±7.4 minutes for standard TUR. The duration of postoperative irrigation after laser resection was lower (4.4±1.8, 4.7±1.6 and 16.4±2.5 hours, respectively) (p<0.001). The period of postoperative catheterization in groups 1 and 2 was 1.5±0.08 and 1.6±0.08 days, respectively, compared to 2.5± 0.13 days in the group 3 (p=0.002). In the group of thulium and holmium laser resection, a higher disease-free survival was demonstrated compared with TUR throughout the entire follow-up period. Conclusion. When performing laser resection of the bladder wall for NMIBC, a significant lower number of complications and better survival were documented compared to patients who underwent TUR.

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About the Authors

Corresponding author: T.A. Lelyavina – Ph.D., MD, leading researcher at the FGBU National Medical Research Center named after V.A. Almazov of the Ministry of Health of the Russian Federation, researcher at the Saint Petersburg GBUZ «City Hospital Saint Luka», Saint Petersburg, Russia; e-mail: tatianalelyavina@mail.com

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