The effect of holmium laser resection versus standard transurethral resection on non-muscle-invasive bladder cancer: a systematic review and meta-analysis

To explore the advantages and limitations of holmium laser resection of the bladder tumor (HOLRBT) versus standard transurethral resection of the bladder tumor (TURBT) in the treatment of non-muscle-invasive bladder cancer (NMIBC), the eligible studies were selected from the following databases: PubMed, Cochrane Library, and Embase. Studies comparing HOLRBT and TURBT for patients with NMIBC were included. The outcomes of interest were time of operation, catheterization and hospitalization, rates of recurrence, and perioperative complications, including obturator nerve reflex, bladder perforation, bladder irritation, and urethral stricture. Results of all data were compared and analyzed by Review Manager 5.3. A total of 9 comparative studies were finally included for this analysis. Pooled data demonstrated that HOLRBT significantly reduced the time to catheterization and hospitalization, the rate of recurrence in 2 years of follow-up, obturator nerve reflex, bladder perforation, and bladder irritation, compared with those in TURBT, respectively. However, no significant difference found between HOLRBT and TURBT in the time of operation, rate of recurrence in 1-year follow-up, and urethral stricture. The results of this research reached that HOLRBT would be a better choice than TURBT for patients with NMIBC.