title: Tm:YAG laser en bloc mucosectomy for accurate staging of primary bladder cancer: early experience.
abstract: BACKGROUND
  Exact pathological staging of bladder cancer is crucial for determination of further treatment. One limiting factor is the surgical 'incise and scatter' technique that might contribute to tumour recurrence. En bloc resection techniques are en emerging issue. We present initial results with Thulium:YAG (Tm:YAG) en bloc resection of bladder tumours for treatment and accurate staging of solitary transitional cell carcinoma of the bladder.
  
  
  METHODS
  From June through October 2010, six patients were treated by TmLRBT (Thulium laser resection of bladder tumour). Inclusion criteria were solitary lesions, treatment naive patients and tumour localisation of the lower bladder wall and trigonum. En bloc resection was applied on all of the tumours. Two cold-cut biopsies from the tumour base were extracted. On five of the six patients, a re-resection was performed after 6 weeks.
  
  
  RESULTS
  Pathological evaluation revealed 1 patient with pTa G1, 2 patients with pTa G2 and 3 patients with pT1 G3. All of the resected specimens provided detrusor muscle, and all biopsies were positive for muscle cells. No intra-, peri- or post-operative complications were observed. Bladder irrigation was mandatory in only 50% of the patients. All patients were negative for residual TCC in re-resection 6 weeks after initial treatment.
  
  
  CONCLUSIONS
  TmLRBT has been proven safe and effective for both, treatment and pathological staging of primary TCC of the bladder. Tm:YAG en bloc resection therefore could be an appropriate tool for accurate staging with possibly lower scattering potential for the assessment and treatment of patients with TCC.
authors.affiliation: Department of Urology and Urological Oncology, Hannover Medical School (MHH), Carl Neuberg Str. 1, 30625, Hannover, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Wolters
authors.forename: Mario W
authors.initials: MW
authors.lastname: Kramer
authors.forename: Jan U
authors.initials: JU
authors.lastname: Becker
authors.forename: Matthias
authors.initials: M
authors.lastname: Christgen
authors.forename: Udo
authors.initials: U
authors.lastname: Nagele
authors.forename: Florian
authors.initials: F
authors.lastname: Imkamp
authors.forename: Martin
authors.initials: M
authors.lastname: Burchardt
authors.forename: Axel S
authors.initials: AS
authors.lastname: Merseburger
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kuczyk
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bach
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Gross
authors.forename: Thomas R W
authors.initials: TR
authors.lastname: Herrmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013932:Thulium / Q000009:adverse effects; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D013932:Thulium