Comparison Between DiLRBT And TURBT In Treatment Of NMIBT

Objective: This paper aims to investigate the efficacy and safety of second generation 980 nm diode laser resection of bladder tumor(DiLRBT)and transurethral resection of bladder tumor(TURBT)in the treatment of non-muscle invasive bladder tumor(NMIBT).Methods: A review was made on clinical data of 70 cases of patients with NMIBT admitted into Qinghai Provincial People 's Hospital from July 2008 to October 2015,including 30 cases treated with DiLRBT(n = 30)or 40 cases treated with TURBT(n = 40).According to different surgical methods,they were assigned into DiLRBT group and TURBT group,and a comparative analysis was made on the intergroup differences in the operation length,intraoperative bleeding volume,obturator nerve reflex,incidences of vesical perforation,urethral stricture and other complications,postoperative indwelling catheterization duration,postoperative length of hospital stay and other intraoperative or postoperative conditions as well as the follow-up situation within postoperative 12 months.Results: There were no statistically significant intergroup differences in age and gender.While the average operation lengths of DiLRBT group and TURBT group were(22.4 ± 2.4)mins and(30.4 ± 7.9)mins respectively,there was a significant difference(P <0.0001).The bleeding volume in DiLRBT group was(17.5 ± 3.5)ml,significantly lower than that in TURBT group(26.5 ± 2.5)ml.There were no case of obturator nerve reflex and no case of vesical perforation in DiLRBT group;while there were 7 cases of obturator nerve reflex and 1 case of vesical perforation due to reflex in TURBT group,this case got a vesical perforation healing after receiving 10 days of indwelling catheterization treatment.There was no case of ureteral stenosis in DiLRBT group;there were 2 cases of ureteral stenosis in TURBT group,regular urethral dilatations were required.There was a significant difference(P = 0.0005)in indwelling catheterization duration between the DiLRBT group(1.41 ± 0.66)days and TURBT group(2.62 ± 2.13)days There was no significant difference(P = 0.7604)in length of hospital stay between the DiLRBT group(3.65 ± 2.85)days and TURBT group(3.85 ± 2.59)days.DiLRBT group and TURBT group were followed up for 12 months.At postoperative months,all cases should revisit and undergo examinations of urinary system Doppler ultrasound or abdominal and pelvic CT and cystoscopy per 3 months.Overall recurrence rate were not statistically significant.Conclusions: 1.Compared with traditional TURBT therapy,DiLRBT therapy has less operation length,intraoperative bleeding volume,lower incidences of obturator nerve reflex and vesical perforation and other complications as well as similar recurrence rate in treatment of NMIBT.2.So it can be used as a safe and reliable surgical procedure for the treatment of NMIBT.