Indian Journal of Urology
ORIGINAL ARTICLE
Year
: 2020  |  Volume : 36  |  Issue : 2  |  Page : 106--111

Safety, feasibility, and quality of holmium laser en-bloc resection of nonmuscle invasive bladder tumors – A single-center experience


Pankaj N Maheshwari, Amandeep Manjeet Arora, Mahesh S Sane, Vivek Ganesh Jadhao 
 Department of Urology, Fortis Hospital Mulund, Mumbai, Maharashtra, India

Correspondence Address:
Pankaj N Maheshwari
Department of Urology, Fortis Hospital Mulund, Mumbai, Maharashtra
India

Introduction: Conventional transurethral resection of bladder tumor (cTURBT), despite its piecemeal resection and associated limitations, remains the most widely practiced technique of TURBT. Resecting the tumor in a single piece would avoid most of the drawbacks of cTURBT. Our objective was to assess the feasibility, safety, and quality of Holmium (Ho) laser en-bloc resection (ERBT) for nonmuscle-invasive bladder cancer (NMIBC). Materials and Methods: We retrospectively studied 67 patients who underwent Ho laser EBRT for primary NMIBC. Data were collected regarding tumor size, number and location, intraoperative complications, and postoperative course. Patients were grouped as first 20, next 20 (21–40), and last 27 cases to assess how the quality of resection improved with increasing experience. Results: The mean tumor size was 28.7 ± 7.9 mm, with 34.3% of the patients having a tumor larger than 3 cm. While 43 patients (64.17%) had a single tumor, the rest had multiple tumors, ranging from 2 to 9 in number. The mean total duration of resection was 38.7 ± 11.6 min. No case required conversion to cTURBT. No patient experienced obturator reflex or bladder perforation. Detrusor muscle was present in 85.07% of the resections. With increasing experience, requirement for bladder irrigation and the incidence of postoperative clot evacuation decreased (P < 0.0001 and P = 0.31, respectively), and the detrusor-positive rate in the specimen increased (P = 0.24). The mean duration of catheterization was 1.76 ± 0.54 days. Conclusion: Ho laser ERBT is safe and feasible for complete resection of NMIBCs with no risk of obturator-nerve reflex and a high rate of detrusor-positive specimens.


How to cite this article:
Maheshwari PN, Arora AM, Sane MS, Jadhao VG. Safety, feasibility, and quality of holmium laser en-bloc resection of nonmuscle invasive bladder tumors – A single-center experience.Indian J Urol 2020;36:106-111


How to cite this URL:
Maheshwari PN, Arora AM, Sane MS, Jadhao VG. Safety, feasibility, and quality of holmium laser en-bloc resection of nonmuscle invasive bladder tumors – A single-center experience. Indian J Urol [serial online] 2020 [cited 2022 May 19 ];36:106-111
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2020;volume=36;issue=2;spage=106;epage=111;aulast=Maheshwari;type=0