Di-san junyi daxue xuebao (Jul 2019)

Efficacy and safety of transurethral laser versus transurethral resection for non-muscle invasive bladder urothelial carcinoma: a meta-analysis

  • TIAN Guanqiang,
  • CHENG Liang,
  • ZHOU Zhihao,
  • CHEN Yanlin,
  • LIANG Chang

Journal volume & issue
Vol. 41, no. 14
pp. 1387 – 1396


Read online

Objective To compare the safety and efficacy of transurethral laser and transurethral resection for treatment of non-muscle invasive bladder cancer (NMIBC). Methods Randomized controlled trials, cohort studies and case-control studies comparing transurethral laser and transurethral resection of NMIBC were retrieved from PubMed, Medline, Embase, Cochrane Library, Web of Science, Social Science Citation Index, China Journal Full-text Database (CNKI), Chinese Biomedical Literature Database and VIP medical database. RevMan 5.3 software was used for meta-analysis of the data extracted from the eligible studies. Results We retrieved 16 eligible studies involving a total of 2 570 patients from the databases. Meta-analysis of the data from these studies showed no significant difference between the 2 surgical modalities in terms of the operation time (MD=-0.70, 95%CI: -2.78~1.38, P=0.51) or the occurrence of postoperative urethral stricture (OR=0.70, 95%CI: 0.24~2.06, P=0.52). Compared with transurethral resection, transurethral laser surgery was associated with significantly lower incidences of intraoperative obturator nerve reflex (OR=0.05, 95%CI: 0.02~0.10; P < 0.001) and bladder perforation (OR=0.11, 95%CI: 0.04~0.29, P < 0.001), shorter postoperative catheterization time (MD=-1.08, 95%CI: -1.46~-0.71, P < 0.001) and length of hospital stay (OR=0.05, 95%CI: 0.02~0.10, P < 0.001), and lower rates of bladder irrigation (OR=0.21, 95%CI: 0.13~0.35, P < 0.001) and postoperative recurrence at 12 months (OR=0.67, 95%CI: 0.48~0.93, P=0.02) and 24 months (OR=0.60, 95%CI: 0.41~0.86, P=0.005). Conclusion Transurethral laser surgery for NMIBC, as compared with transurethral resection, is associated with lower incidences of intraoperative complications (obsessive nerve reflex and bladder perforation), a lower postoperative recurrence rate, and faster postoperative recovery.