Green-light Laser Vaporization And TURBT For The Treatment Of Superficial Bladder Cancer:A Meta-analysis

Objective:By using the principle and method of evidence-based medicine,to objectively evaluate the advantages and disadvantages of greenlight laser photoselective vaporization of bladder tumor(PVBT)versus trasnurethral resection of bladder tumor(TURBT)in treating the non muscle-invasive bladder cancer(NMIBC).to provide the best evidence for clinical physicians,so as to better serve the clinical.Methods:A search strategy was developed to search for randomized controlled clinical trials of PVBT and TURBT in the treatment of NMIBC,such as CNKI,Wanfang,VIP,PubMed,Embase,CENTRAL and other major databases.The retrieval time was set from building database to October 2017.The retrieval results follow the inclusion of exclusion criteria,select and evaluate the quality of the selected literature one by one,and Finally,the qualified literature was selected and included in the study.Extracting basic data from the research literature,meta analysis of the literature data by RevMan5.3 software,and draw the final conclusion.Objective to compare their advantages and disadvantages in terms of operative time,blood loss during operation,hospitalization days,catheter indwelling time,bladder irrigation time,obturator nerve reflex,bladder perforation,urethral stricture and recurrence.Results:18 papers were included in the literature,of which 2 were high quality literature,and the rest were low quality literature.The total number of cases was 1648 cases,835 cases in group PVBT and 813 in group TURBT.The results of Meta analysis showed that the obturator nerve reflex,bladder perforation and recurrence index,comprehensive effect of volume in the PVBT side,and far from the invalid line,that in the obturator nerve reflex and bladder perforation and postoperative recurrence PVBT compared with TURBT has obvious advantages,and the research between high homogeneity,no conclusion the publication bias,high credibility.The Meta analysis showed that PVBT was also superior to TURBT on the amount of bleeding,the days of hospitalization,the time of bladder irrigation,and the length of the catheter indwelling time.The heterogeneity of the four indicators is very large,but further sensitivity analysis suggests that the results of the four indicators are still reliable.After Meta analysis,there was no difference in the incidence and duration of postoperative urethral stricture between the two operation methods.Sensitivity analysis showed that the results were also stable.Meta analysis showed no significant difference in the length of operation,but sensitivity analysis showed that the conclusion was not reliable.Conclusions:In the treatment of NMIBC,PVBT is better than TURBT,and it is worth further promoting the operation.