TECHNICAL ASPECTS OF LASER EN BLOC RESECTION OF THE BLADDER TUMOR FOR NON-MUSCLE-INVASIVE BLADDER CANCER

Abstract: In recent decades bladder cancer has become one of the most topical problems of modern healthcare due to its widespread distribution. This makes it necessary to investigate new effective methods of surgical treatment.
Objective: Assessment of the effectiveness of en bloc resection of the bladder with tumor by analyzing scientific publications on this matter.
Materials and methods: We have analyzed current articles related to this topic on the databases Pubmed and Google Scholar. The search was performed using the keywords «Bladder Tumor», «En bloc resection of the bladder wall», «non-muscle-invasive bladder cancer».
Results: Most studies confirm the advantages of laser en bloc resection over other methods in terms of such parameters as the frequency of recurrence, macrohematuria, and the quality of morphological material.
Conclusions: Laser en bloc resection of a bladder tumor without invasion of the muscle layer is a safe and effective operation that has a number of advantages over classical transurethral resection, namely: no obturator syndrome, high-quality material for pathomorphological research, low recurrence rate.

1. Jemal A., Bray F., Center M.M., Ferlay J., Ward E., Forman D. Global cancer statistics. CA Cancer J Clin, 2011, 61(2), pp. 69–90.

2. Antoni S., Ferlay J., Soerjomataram I., Znaor A., Jemal A., Bray F. Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends. Eur Urol, 2017, 71(1), pp. 96–108.

3. Ridge C.A., Pua B.B., Madoff D.C. Epidemiology and staging of renal cell carcinoma. Semin Intervent Radiol, 2014, 31(1), pp. 3–8.

4. Tyson M.D., Lee D., Clark P. New developments in the management of nonmuscle invasive bladder cancer. Curr Opin Oncol, 2017, 28, pp. 179183

5. Babjuk M., Burger M., Compérat E., Gontero P., Mostafid A.H., Palou J. et al. EAU Guidelines on Non-muscle-invasive Bladder Cancer (Ta, T1 and CIS). European Association of Urology, 2019, pp. 4-40 p.

6. Martov A. G., Ergakov D. V., Baykov N. A., Pominalnaya V. M., Solomatnikov I. A. Transurethral en bloc resection of bladder tumors. Onkourologiya, 2015, No.1, pp. 41–9. [In Russ].

7. Bryan R.T., Collins S.I., Daykin M.C., Zeegers M.P., Cheng K.K., Wallace D.M.A. et al. Mechanisms of recurrence of Ta/T1 bladder cancer. Ann R Coll Surg Engl, 2010, 92(6), pp. 519–24.

8. Kamat A.M., Bagcioglu M., Huri E. What is new in non-muscleinvasive bladder cancer in 2016? Turkish J Urol, 2017, 43(1), pp. 9–13.

9. Grimm M-O., Steinhoff C., Simon X., Spiegelhalder P., Ackermann R., Vogeli T.A. Effect of routine repeat transurethral resection for superficial bladder cancer: a long-term observational study. J Urol, 2003, 170(2 Pt 1), pp. 433–7.

10. Staehler G., Schmiedt E., Hofstetter A. [Destruction of bladder neoplasms by means of transurethral neodym-YAG-laser coagulation]. Helv Chir Acta, 1978, 45(3), pp. 307–11.

11. Kawada T., Ebihara K., Suzuki T., Imai K., Yamanaka H. A new technique for transurethral resection of bladder tumors: rotational tumor resection using a new arched electrode. J Urol, 1997, 157(6), pp. 2225–6.

12. Kramer M.W., Rassweiler J.J., Klein J., Martov A., Baykov N., Lusuardi L. et al. En bloc resection of urothelium carcinoma of the bladder (EBRUC): a European multicenter study to compare safety, efficacy, and outcome of laser and electrical en bloc transurethral resection of bladder tumor. World J Urol, 2015, 33(12), pp. 1937–43.

13. Herrmann T., Liatsikos E.N., Nagele U., Traxer O., Merseburger A. European Association of Urology Guidelines on Laser Technologies. Actas Urológicas Españolas (English Ed.), 2013, Feb 1(37), pp.63–78.

14. Babjuk M., Bohle A., Burger M., Capoun O., Cohen D., Comperat E.M. et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol, 2017, 71(3), pp. 447–61.

15. Wu Y-P., Lin T-T., Chen S-H., Xu N., Wei Y., Huang J-B. et al. Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor: A meta-analysis. Medicine (Baltimore), 2016, 95(45), p. e5372.

16. Mori K., D’Andrea D., Enikeev D.V., Egawa S., Shariat S.F. En bloc resection for nonmuscle invasive bladder cancer: review of the recent literature. Curr Opin Urol, 2020, 30(1), pp. 41–7.

17. Kislyakov D.A., Severgina L.O., Tsarichenko D.G., Rapoport L.M., Korovin I.A., Sorokin N.I. [Novel approaches for transurethral en-bloc resection of large bladder tumors]. Urologiia, 2019, 4, pp. 105–11.