TY - JOUR
T1 - Experts’ recommendations in laser use for the treatment of bladder cancer
T2 - a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training and Research in Urological Surgery and Technology (TRUST)-Group
AU - Ortner, Gernot
AU - Güven, Selcuk
AU - Somani, Bhaskar Kumar
AU - Nicklas, Andre
AU - Teoh, Jeremy Yuen-Chun
AU - Goumas, Ioannis Kartalas
AU - Bach, Thorsten
AU - Sancha, Fernando G. mez
AU - Figueredo, Felipe C. A.
AU - Kramer, Mario W.
AU - Bozzini, Giorgio
AU - Ulvik, Øyvind
AU - Kallidonis, Panagiotis
AU - Roche, Jean Baptiste
AU - Miernik, Arkadiusz
AU - Enikeev, Dmitry
AU - Vaddi, Chandra Mohan
AU - Bhojani, Naeem
AU - Sountoulides, Petros
AU - Lusuardi, Lukas
AU - Baard, Joyce
AU - Gauhar, Vineet
AU - Ahmed, Ali
AU - Netsch, Christopher
AU - Gözen, Ali Serdar
AU - Nagele, Udo
AU - Herrmann, Thomas R. W.
AU - Tokas, Theodoros
N1 - Publisher Copyright: © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
PY - 2024/12/1
Y1 - 2024/12/1
N2 - 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.
AB - 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.
KW - Bladder cancer
KW - En-bloc
KW - Laser
KW - Settings
KW - Survey
KW - Vaporization
UR - http://www.scopus.com/inward/record.url?scp=85185218736&partnerID=8YFLogxK
U2 - 10.1007/s00345-024-04786-9
DO - 10.1007/s00345-024-04786-9
M3 - Article
C2 - 38353743
SN - 0724-4983
VL - 42
JO - World Journal of Urology
JF - World Journal of Urology
IS - 1
M1 - 79
ER -