| Objective: The aim of this study was to evaluate the efficacy of intravesical instillation following trans-urethral thulium laser en bloc resection of bladder tumor(Tm LERBT)in patients with non-muscle invasive bladder cancer(NMIBC),and to explore whether it could avoid second resection with this method.Methods: One hundred and thirty-five patients with NMIBC who underwent Tm LERBT in combination with intravesical instillation and need the second resection according to the CUA guidelines divided into two groups between June 2012 and November 2016 were retrospectively analyzed.Second TUR was performed within 2~6wk after the initial Tm LERBT for the patients of group A,second TUR was not done but received cystoscopy or surgery at 3 months in group B.This study recorded operative findings and pathological features,recurrence and progression during the follow-up period.Results: No resdiual tumor was detected histopathologically of 60 patients in group A,but recurrence was observed in 3 of these patients and 1 had upper-stage(p T2)disease.There was no statistic difference in general conditions and tumor characteristics during the initial Tm LERBT.The mean follow-up period was 19.6 mo without a significant difference between the groups(P=0.30).Recurrence was observed in 9 of the 57 patients in group A and 13 of the 72 patients in group B(P=0.34).Progression was observed 3.4% of patients for group A compared to 4.5%of patients for group B(P=0.20).Conclusion: Tm LERBT combined with intravesical instillation of NMIBC can remove the tumor tissue completely and provide adequate specimens for pathological grading and clinical staging.For patients who need the second resection,tumor recurrence or progression in short term between second TUR was performed within 2~6wk and treatment according to the countercheck during 3 months,but a second resection should be avoided need long-term and large sample clinical study. |
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