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01-12-2024 | Laser | Topic Paper

Experts’ recommendations in laser use for the treatment of bladder cancer: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training and Research in Urological Surgery and Technology (TRUST)-Group

Authors: Gernot Ortner, Selcuk Güven, Bhaskar Kumar Somani, Andre Nicklas, Jeremy Yuen-Chun Teoh, Ioannis Kartalas Goumas, Thorsten Bach, Fernando Gómez Sancha, Felipe C. A. Figueredo, Mario W. Kramer, Giorgio Bozzini, Øyvind Ulvik, Panagiotis Kallidonis, Jean Baptiste Roche, Arkadiusz Miernik, Dmitry Enikeev, Chandra Mohan Vaddi, Naeem Bhojani, Petros Sountoulides, Lukas Lusuardi, Joyce Baard, Vineet Gauhar, Ali Ahmed, Christopher Netsch, Ali Serdar Gözen, Udo Nagele, Thomas R. W. Herrmann, Theodoros Tokas

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

To identify laser settings and limits applied by experts during laser vaporization (vapBT) and laser en-bloc resection of bladder tumors (ERBT) and to identify preventive measures to reduce complications.

Methods

After a focused literature search to identify relevant questions, we conducted a survey (57 questions) which was sent to laser experts. The expert selection was based on clinical experience and scientific contribution. Participants were asked for used laser types, typical laser settings during specific scenarios, and preventive measures applied during surgery. Settings for a maximum of 2 different lasers for each scenario were possible. Responses and settings were compared among the reported laser types.

Results

Twenty-three of 29 (79.3%) invited experts completed the survey. Thulium fiber laser (TFL) is the most common laser (57%), followed by Holmium:Yttrium–Aluminium-Garnet (Ho:YAG) (48%), continuous wave (cw) Thulium:Yttrium–Aluminium-Garnet (Tm:YAG) (26%), and pulsed Tm:YAG (13%). Experts prefer ERBT (91.3%) to vapBT (8.7%); however, relevant limitations such as tumor size, number, and anatomical tumor location exist. Laser settings were generally comparable; however, we could find significant differences between the laser sources for lateral wall ERBT (p = 0.028) and standard ERBT (p = 0.033), with cwTm:YAG and pulsed Tm:YAG being operated in higher power modes when compared to TFL and Ho:YAG. Experts prefer long pulse modes for Ho:YAG and short pulse modes for TFL lasers.

Conclusion

TFL seems to have replaced Ho:YAG and Tm:YAG. Most laser settings do not differ significantly among laser sources. For experts, continuous flow irrigation is the most commonly applied measure to reduce complications.

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Title: Experts’ recommendations in laser use for the treatment of bladder cancer: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training and Research in Urological Surgery and Technology (TRUST)-Group
Authors: Gernot Ortner
Selcuk Güven
Bhaskar Kumar Somani
Andre Nicklas
Jeremy Yuen-Chun Teoh
Ioannis Kartalas Goumas
Thorsten Bach
Fernando Gómez Sancha
Felipe C. A. Figueredo
Mario W. Kramer
Giorgio Bozzini
Øyvind Ulvik
Panagiotis Kallidonis
Jean Baptiste Roche
Arkadiusz Miernik
Dmitry Enikeev
Chandra Mohan Vaddi
Naeem Bhojani
Petros Sountoulides
Lukas Lusuardi
Joyce Baard
Vineet Gauhar
Ali Ahmed
Christopher Netsch
Ali Serdar Gözen
Udo Nagele
Thomas R. W. Herrmann
Theodoros Tokas
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keyword: Laser
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04786-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Experts’ recommendations in laser use for the treatment of bladder cancer: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training and Research in Urological Surgery and Technology (TRUST)-Group

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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