Category: Other, Miscellaneous

VS4-1 - Holmium laser En Bloc Resection of bladder Tumour; A new quality control

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

Holmium Laser En Bloc Resection Of Bladder Tumor (HoL.EBRBT) is an appealing approach to treat non-muscle-invasive bladder cancer (NMIBC). Caveats of conventional transurethral resection of the bladder tumor (cTURBT) include lack of detrosur muscle sampling, incompleteness of resection, bleeding, risk of obturator jerk and cautery artifact with the resected specimen.


This video aims at presenting the feasibility of HoL.EBRBT in different situations either as primary or salvage treatment approach.


Methods :

Among 44 HoL.EBRBT procedures, 2 were done as salvage procedures due to complicated cTURBT between September 2015 and September 2017.


Operative time, tumor criteria including location, size, number and morphology were reported.


All patients were subjected to guidelines-endorsed restaging cTUR biopsy after 2-6 weeks.


HoL.EBRBT technique was presented.


Results :

Among 44 procedures; no obturator jerk, perforations nor bleeding were reported. HoL.EBRBT was performed for multiple tumors in 13 (29.5%), non-papillary morphology in 5 (11.4%) with mean overall tumour size 3.6 ±1.3cm.


HoL.EBRBT was performed for tumours in posterior wall  ± domal in 20 (45.4%), lateral wall ± other site in 21 (47.7%) and anterior wall in 3 (6.8%) patients.


Detrosur muscle sample was evident in all specimens. Final histopathology showed benign lesion in 2 (4.5%), PUNLMP in 2 (4.5%) and urothelial cancer staged Ta in 34 (77.3%), T1 in 2 (4.5%), T1 with CIS in 1 (2.3%) and T2 in 3 (6.8%) patients.


All patients received immediate postoperative intravesical Epirubcin.


On restaging cTUR biopsy, only one patient (2.3%) had residual tumor.


Conclusions :

HoL.EBRBT, is safe and effective method for treatment of NMIBC.


Randomized trial of HoL.EBRBT vs. cTURBT is ongoing [NCT02555163].

Ahmed M. Elshal

Lecturer
Urology and Nephrology Center, Mansoura University, Egypt.
Mansoura, Ad Daqahliyah, Egypt

Abdelwahab Hashem

Clinical fellow
Urology and Nephrology Center, Mansoura University, Egypt.
Mansoura, Ad Daqahliyah, Egypt

Ahmed Mosbah

Urology and Nephrology Center, Mansoura University, Egypt.
Mansoura, Ad Daqahliyah, Egypt

Nasr Eltabey

Urology and Nephrology Center, Mansoura University, Egypt.
Mansoura, Ad Daqahliyah, Egypt

Elhoussieny Ibrahim

Urology and Nephrology Center, Mansoura University, Egypt.
Mansoura, Ad Daqahliyah, Egypt

Islam F. Eldiasty

specialist urologist
Mansoura urology and nephrology center
Mansoura, Ad Daqahliyah, Egypt