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      Initial experience of 980‐nm diode laser treatment for recurrent non‐muscle‐invasive bladder cancer

      case-study

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          Abstract

          Introduction

          Laser ablation using a 980‐nm wavelength diode laser, which is a new‐generation laser, for recurrent bladder cancer is known to have a lower incidence of complications and recurrence than conventional transurethral resection of bladder tumor surgery. This is the first study to report the use of 980‐nm diode laser ablation for recurrent non‐muscle‐invasive bladder cancer in Japan.

          Case presentation

          A 73‐year‐old man underwent transurethral laser ablation for the treatment of recurrent non‐muscle‐invasive bladder cancer. Laser irradiation was performed using LEONARDO DUAL (diode laser/980‐nm wavelength) and a 400‐μm BARE laser fiber. Pathological evaluation indicated low‐grade urothelial carcinoma, pTa. The patient was discharged on the second postoperative day with no perioperative or postoperative complications.

          Conclusion

          This case suggests the potential of transurethral laser ablation for treating recurrent non‐muscle‐invasive bladder cancer.

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          Most cited references7

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          980-nm Diode laser: a novel laser technology for vaporization of the prostate.

          The wavelength 980 nm of a recently introduced diode laser system for treatment of benign prostatic enlargement offers a high simultaneous absorption in water and haemoglobin, and is postulated to combine high tissue ablative properties with a good haemostasis. The Ceralas HPD150 diode laser system was evaluated in the well-established ex vivo model of the isolated blood-perfused porcine kidney to evaluate tissue ablation capacity and haemostatic properties at different generator settings. A histological examination of the ablated renal tissue followed. The results were compared with the reference standards transurethral resection of the prostate (TURP) and potassium-titanyl-phosphate (KTP) laser. The diode laser displays a higher tissue ablation capacity, reaching 7.24+/-1.48 g after 10 min, compared with the KTP laser (3.99+/-0.48 g; p<0.05), whereas only 30s are needed to resect the tissue in the same surface area using TURP, resulting in 8.28+/-0.38 g of tissue removal. With a bleeding rate of 0.14+/-0.07 g/min, the diode laser offers haemostatic properties equivalent to the KTP laser (0.21+/-0.07 g/min) and a significantly reduced bleeding compared with TURP (20.14+/-2.03 g/min; p<0.05). The corresponding depths of the coagulation zones are 290.1+/-46.9 microm for the diode laser, 666.9+/-64.0 microm for the KTP laser (p<0.05), and 287.1+/-27.5 microm for TURP. In the standardised ex vivo investigation, the 980-nm diode laser offers a higher tissue ablation capacity and similar haemostasis compared with the KTP laser. In comparison with TURP, both tissue ablation and bleeding are significantly reduced. The promising ex vivo results warrant further clinical investigation.
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            Adjuvant laser treatment of bladder cancer: 8 years' experience with the Nd-YAG laser 1064 nm.

            Following the development of suitable equipment for the endoscopic application of an Nd-YAG laser in this department, the laser has been used routinely in the management of bladder cancer since 1978. To evaluate side effects and efficiency, 252 consecutive laser treatments were evaluated with a minimum follow-up of 12 months. Side effects were few (0.3% perforation) and patients tolerated the treatment very well. The general recurrence rate of T1 tumours varied from 33% for primary carcinomas to 54% for recurrent tumours, but the incidence of local recurrence was only 7%. The long-term results of laser treatment showed a decrease in the local recurrence rate when compared with the results of conservative electocautery resection, but there was no significant influence on the total recurrence rate.
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              The future of lasers in urology.

              The use of laser applications in urology has undergone significant advances over the past 20 years. Laser technology is now used in a wide variety of procedures, and has become the primary treatment modality or standard of care for many urologic conditions. Despite these advances, a number of challenges still face laser utilization in urologic practice. Recent work has illuminated the potential improvement and further optimization of this field. Improvements in types of lasers, the wavelength of energy used, optical fiber delivery systems, precision of laser application and cost reduction have served to further improve laser technology and extend the potential applications.
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                Author and article information

                Contributors
                jm-fukuhara@kochi-u.ac.jp
                Journal
                IJU Case Rep
                IJU Case Rep
                10.1002/(ISSN)2577-171X
                IJU5
                IJU Case Reports
                John Wiley and Sons Inc. (Hoboken )
                2577-171X
                25 October 2024
                January 2025
                : 8
                : 1 ( doiID: 10.1002/iju5.v8.1 )
                : 41-43
                Affiliations
                [ 1 ] Department of Urology Kochi Medical School Nankoku Kochi Japan
                Author notes
                [*] [* ] Correspondence: Hideo Fukuhara Ph.D., Department of Urology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, Japan. Email: jm-fukuhara@ 123456kochi-u.ac.jp

                Author information
                https://orcid.org/0000-0002-9079-0995
                https://orcid.org/0000-0002-6917-854X
                https://orcid.org/0000-0001-7338-8059
                Article
                IJU512803 IJUCR-2024-0103.R1
                10.1002/iju5.12803
                11693092
                39749299
                d6d2fc08-f949-4701-be44-a1b6fd9fae39
                © 2024 The Author(s). IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 21 June 2024
                : 16 October 2024
                Page count
                Figures: 2, Tables: 0, Pages: 3, Words: 1934
                Categories
                Case Report
                Case Report
                Custom metadata
                2.0
                January 2025
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.1 mode:remove_FC converted:01.01.2025

                diode laser therapy,non‐muscle‐invasive bladder cancer,transurethral laser ablation

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