(UroToday.com) At the WCET 2024 conference in Seoul, Dr. Mohammad Mohsen Mazloumfard from the Department of Internal Medicine at Modarres Hospital, Shahid Beheshti University of Medical Sciences, presented an insightful study comparing two surgical techniques for the treatment of non-muscle-invasive bladder cancer (NMIBC): Holmium Laser Resection of Bladder Tumor (HoLRBT) and the traditional Transurethral Resection of Bladder Tumor (TURBT). The research aimed to assess the safety and efficacy of HoLRBT as a potential alternative to the more commonly used TURBT procedure.
In this study, 79 patients diagnosed with primary non-muscle-invasive bladder cancer were randomly assigned to undergo either HoLRBT or TURBT. The research team compared the intraoperative and postoperative outcomes of both groups, focusing on several critical factors such as operation time, occurrence of obturator nerve reflex, bladder perforation, bladder irrigation requirements, catheterization duration, hospital stay, and recurrence-free survival at intervals of 1, 3, 6, 12, 18, and 24 months.
The findings revealed no significant differences in the duration of surgery between the two groups. However, patients who underwent HoLRBT experienced fewer complications both during and after surgery. Notably, there was a marked reduction in the incidence of obturator nerve reflex, transient hematuria, and postoperative bladder irritation among those treated with HoLRBT. Additionally, these patients had shorter catheterization periods and hospital stays compared to their counterparts in the TURBT group.
Long-term outcomes showed no significant differences in the overall recurrence rates between the two groups, indicating that both methods are comparably effective in preventing cancer recurrence.
In conclusion, while TURBT remains the standard approach for managing non-muscle-invasive papillary urothelial carcinoma, Dr. Mazloumfard's study highlights HoLRBT as a safe and feasible alternative. The reduction in intraoperative complications such as obturator nerve reflex, bladder perforation, and bleeding positions HoLRBT as a promising option for the surgical management of NMIBC.
The presentation also included a lively Q&A session. The moderator began by asking whether the procedures were performed in an outpatient or inpatient setting. Dr. Mazloumfard clarified that both procedures were conducted in an inpatient hospital setting. Another audience member inquired about whether histology and pathology were conducted for the tumors. The presenter responded that post-tumor resection samples were sent for further pathological examination and if tumors were not NMIBC, they were excluded from studies.
A subsequent question addressed the tumor size margin used in the study. Dr. Mazloumfard responded that tumors with a size of up to 4 cm were included as the cut-off. Additionally, when asked whether any morcellation was used to remove the tumors, the presenter clarified that no morcellation was used; instead, the surgeon ablated the tumors into small pieces and washed them out.
The authors of the study disclosed that they have no proprietary interests in the research, ensuring the impartiality of their findings.
Presented by: Mohammad Mohsen Mazloumfard, MD, Department of Internal Medicine, Modarres Hospital, LASER Application in Medical Sciences Research Center (LAMSRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Written by: Seyedamirvala Saadat, Research Specialist, Department of Urology, University of California Irvine, @Val_Saadat on X during the 2024 World Congress of Endourology and Uro-Technology: August 12 -16, 2024, Seoul, South Korea