Clinical application of 1 470 nm laser suspending enucleation for the treatment of non-muscle-invasive bladder tumor

Objective To To evaluate the clinical efficacy and surgical skills of 1 470 nm-laser suspended enucleation in the treatment of non-muscle-invasive bladder tumors. Methods Clinical data of 22 patients with non-muscle-invasive bladder tumors admitted to our hospital from April, 2016 to March, 2017 were retrospectively analyzed. All patients underwent 1 470 nm-laser suspended enucleation. The diluted methylene blue solution was injected into the submucosal ring 2 cm from the edge of the tumor base with a disposable bladder injection needle to separate the tumor base from the muscle layer. The fiber was directly irradiated with 1 470 nm laser with a laser power of 70-80 W. The bladder mucosa and submucosa were incised along the ring-shaped injection mark surrounding the tumors. Then, the separation plane between the tumor base and the muscle layer stained with methylene blue was observed, and the head end of the metal sheath of optical fiber was inserted into the separation plane to pull the tumor out of the muscle layer for enucleation. The operation time, bleeding volume, intraoperative and postoperative complications were recorded. Results The surgery was successfully performed in 22 cases with an average operation time of (30±9) min. No intraoperative complications such as bleeding, obturator nerve reflex and bladder perforation occurred. No bladder irrigation was required after the operation. The catheter was retained for 72 h. During postoperative follow-up for 3 to 18 months, no recurrence of tumor, urethral stricture or massive bleeding occurred. Conclusion The 1 470 nm-laser suspended enucleation is an efficacious and safe management of non-muscle-invasive bladder tumors, which has multiple advantages, such as short operation time, mild bleeding, high safety and intact tumor morphology, etc. Key words: Bladder tumor; Suspension method; Enucleation; 1 470 nm laser