A Pilot Study of Vela Laser for En Bloc Resection of Papillary Bladder Cancer

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Abstract

Micro-Abstract

Transurethral resection of bladder tumors is associated with perioperative or postoperative complications, and an “incise and scatter” procedure contradicts basic oncologic principles. The present study introduces the Vela laser, a new type of thulium laser with a 1.94-μm wavelength, for en bloc resection of bladder tumors. The pilot experience found the Vela laser could preserve the muscle layer and was effective, feasible, and safe for patients with bladder tumors.

Introduction:

The present study evaluated the safety and efficacy of the Vela laser for en bloc resection of papillary bladder tumors.

Materials and Methods:

From January 2013 to August 2014, 38 patients underwent en bloc resection with the Vela laser and a 26F continuous flow resectoscope or 18F flexible cystoscope. Random cold forceps biopsy samples were also taken. The total operation time, pathologic result, and intraoperative and postoperative complications were recorded. Each patient was followed up for ≥ 1 year.

Results:

The average total operation time was 23 minutes. The en bloc resection of all tumors was successful, with 2 cases located at the bladder dome requiring the use of a flexible cystoscope for better management. No complications occurred during or after surgery. All resected tumors were intact with the detrusor muscle layer and architecture available for pathologic evaluation. One patient with stage T2b tumor underwent laparoscopic cystectomy 1 week after the initial surgery. At a median follow-up period of 21.8 months, the recurrence rate at 12 months was 21.6% (8 of 37).

Conclusion:

The results of our study have shown that the Vela laser is an effective, feasible, and safe thulium laser for en bloc bladder tumor resection. It was associated with negligible complications and allows accurate pathologic evaluation. The Vela laser can serve as an alternative treatment method for nonmuscle-invasive bladder cancer or infiltrating tumor.

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