A Review of How Lasers Are Used in UTUC Surgery: Can the Choice of Laser Affect Outcomes?

Author:

Taratkin Mark1ORCID,Singla Nirmish23,Babaevskaya Diana1,Androsov Alexander4,Shariat Shahrokh F.156789ORCID,Fajkovic Harun510,Baniel Jack1112,Enikeev Dmitry1510

Affiliation:

1. Institute for Urology and Reproductive Health, Sechenov University, 119435 Moscow, Russia

2. Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

3. Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

4. Institute for Clinical Medicine, Sechenov University, 119021 Moscow, Russia

5. Department of Urology, Medical University of Vienna, 1030 Vienna, Austria

6. Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA

7. Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA

8. Division of Urology, Department of Special Surgery, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman 19328, Jordan

9. Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic

10. Karl Landsteiner Institute of Urology and Andrology, 3100 Vienna, Austria

11. Division of Urology, Rabin Medical Center, Petach Tikva 4920232, Israel

12. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel

Abstract

Upper tract urothelial carcinoma (UTUC) is a relatively rare disease with an aggressive phenotype compared to urothelial carcinoma in the bladder. In recent years, kidney-sparing surgery (KSS) and, in particular, endoscopic surgery have become the procedure of choice among urologists where the treatment of localized UTUC is concerned. Endoscopy tends to result in satisfactory oncological disease control while lowering morbidity and minimizing complications amongst the appropriately selected cohort of patients. While endoscopic surgery for UTUC might appear to be standardized, it, in fact, differs considerably depending on the source of energy used for resection/ablation. There has been little reliable data up to now on which laser energy source is the most superior. The goal of this review is, therefore, to outline the results of endoscopic UTUC treatment using different lasers and to analyze how these laser-tissue interactions may affect the surgery. We start by pointing out that the data remains insufficient when trying to determine which laser is the most effective in the endoscopic management of UTUC. The ever-growing number of indications for minimally invasive treatment and the increasing number of centers using laser surgery will, hopefully, lead to novel randomized controlled trials that compare the performance characteristics of the lasers as well as the effects of UTUC on patients.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference61 articles.

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2. Rouprêt, M., and Babjuk, M. (2022). Upper Urinary Tract Urothelial Carcinoma EAU Guidelines on 2022, EAU Central Office.

3. Oncologic Outcomes of Kidney-sparing Surgery Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review by the EAU Non-muscle Invasive Bladder Cancer Guidelines Panel;Seisen;Eur. Urol.,2016

4. Ureteroscopic and percutaneous management of upper tract urothelial carcinoma (UTUC): Systematic review;Cutress;BJU Int.,2012

5. Long term outcomes of ureteroscopic management of upper tract urothelial carcinoma;Scotland;Urol. Oncol. Semin. Orig. Investig.,2020

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