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Laser Versus Electrical En Bloc Resection of Bladder Tumors

By: Celeste L. Dixon
Posted: Monday, October 4, 2021

No conversions to transurethral resection of a bladder tumor were needed after laser en bloc resection of bladder tumors, whereas due to technical failure, two such conversions were required after electrical en bloc resection of bladder tumors (P = .146), according to the results of a 106-patient randomized trial presented during the 2021 American Urological Association (AUA) Annual Meeting (Abstract MP16-04) and published in The Journal of Urology. All patients had cystoscopic evidence of non–muscle-invasive bladder cancer, reported Ahmed Elshal, MD, PhD, of Mansoura University, Egypt, and colleagues.

Their study goals were to assess the need for conversion to conventional transurethral resection of a bladder tumor post en bloc resection of bladder tumors and to clarify the noninferiority of laser versus electrical en bloc resection of bladder tumors. The baseline characteristics of both the patients and their tumors were comparable in the two cohorts. More resection time was reported during laser en bloc resection of bladder tumors (P = .04). However, no intraoperative complications occurred in the laser group. In contrast, intraoperative obturator kick or bladder perforation was reported in 17.3% of the patients who underwent electrical en bloc resection of bladder tumors (P = .002).

No statistical difference emerged between the groups regarding the duration of a urethral catheter (P = .2) and hospital stay (P = .9). Detrusor muscle was sampled in 59.3% and 53.8% (P = .574), and residual tumors at second look were detected in 6.5% and 2.6% (P = .391) of the laser and electrical en bloc resection groups, respectively. Given the results, “laser en bloc resection of bladder tumors seems to be [a] safer procedure for bladder tumor resection…when compared [with] electrical en bloc resection of bladder tumors,” concluded the team.

Disclosure: The study authors reported no conflicts of interest.



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