Meta-Analysis Of2Micron Laser In The Treatment Of Non Muscle-invasive Bladder Tumor

Objective:To evaluate the difference of curative effect between2-μm laser and transurethral resection of bladder tumor in treatment of non-muscle-invasive bladder tumor, and to provide medicine-based evidence for clinical application. Methods:An online retrieval of PubMed, Ovid, Medline, Embase, Cochrane Library, CBM,CNKI, Wanfang database, Weipu database and Superstar database was performed. We also supplemented by manual and other retrieval. The retrieval time arranged from inception until September30,2013. Randomized controlled trials of2-μm laser and transurethral resection of bladder tumor in treatment of non-muscle invasive bladder tumor were searched. Meta analysis was performed using RevMan5.2software after the data were abstracted and the quality was evaluated. Results:Four randomized controlled trials involving310patients were included,161cases in2-μm laser group and149cases in transurethral resection of bladder tumor group. The results of Meta analysis showed that compared with transurethral resection of bladder tumor group, postoperative bladder irrigation time (SMD=-3.61,95%CI [-4.41,-3.13]) and period of catheterization (MD=-1.47,95%CI [-2.32,-0.62]) were shorter in2-μm laser group, with less incidence of obturator nerve reflex (RR=0.07,95%CI[0.01,0.34]), bladder irritation(RR=0.30,95%CI [0.19,0.47]) and bladder perforation (RR=0.09,95%CI [0.02,0.45]). There were no significant differences in operation time, period of hospitalization, postoperative urethral stricture incidence and bladder tumor recurrence rate in short-term between the two groups. Conclusion Experimental findings indicate that,2-μm laser is similar to transurethral resection of bladder tumor in treatment of non-muscle invasive bladder tumor. But the incidence of obturator nerve reflex, bladder irrigation and bladder perforation is lower, postoperative bladder irrigation time and period of catheterization were shorter than transurethral resection of bladder tumor. So2-μlaser is a minimally invasive technique with definite effect and relatively high safety. Due to the quality of the included studies and possible publication bias, the above conclusions still need more high-quality randomized controlled trials to validate.