ALEXANDRE ISCAIFE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- En Bloc Resection of Bladder Tumors (ERBT) using different lasers - Hybrid and Holmium Laser(2023) ISCAIFE, Alexandre; SOCARRAS, Moises Rodriguez; GONZALEZ, Luis Llanes; RIVAS, Juan Gomez; PEREIRA, Maykon William Aparecido Pires; LEITE, Katia Ramos Moreira; NAHAS, Willian Carlos; SANCHA, Fernando Gomez
- Holmium Laser Resection of Large Bladder Tumors: Technique Description, Feasibility, and Histopathological Quality Analysis(2022) ISCAIFE, Alexandre; RIBEIRO FILHO, Leopoldo Alves; PEREIRA, Maikon Willian Aparecido; GALLUCCI, Fabio Pescarmona; CHADE, Daher; MURTA, Claudio Bovolenta; CORDEIRO, Mauricio Dener; CARDILI, Leonardo; SARKIS, Alvaro Sadeki; SROUGI, Miguel; NAHAS, William C.BACKGROUND The HoLERBT (Holmium Laser En-bloc Resection of Bladder Tumors) has emerged as an alternative to classical TURBT (Transurethral Resection of Bladder Tumor). Recent randomized trial and meta-analysis corroborate with the benefits in pathological analysis, perioperative and longterm oncological outcomes.(1-3) However, the treatment of large tumors and the technique of extraction from the bladder is a problem to be overcome.(1,4) OBJECTIVE To describe the laser resection of bladder tumors and demonstrate the feasibility of this procedure even for large tumors throughout a series of cases. It is also discussed the quality of the histopathological analysis. METHODS A series of 8 cases randomized selected to be the pilot for a trial comparing TURBT and HoLERBT in large tumors (>3 cm) in progress was analyzed (Brazilian Registry of Clinical Trials number RBR-67npwrk). The perioperative data and 1-year outcomes were assessed and the quality of histopathological analysis after morcellation was evaluated in terms of histopathology, grade, and stage. The entire procedure of one case is shown in a step-by-step video. RESULTS The mean follow-up was 12.6 months. The mean age was 59.6 (42-85) years, and the mean tumor size was 4.7 (4-8) cm. All the resections were En-bloc. There were 2 cases of NMIBC, 4 cases of MIBC, 1 paraganglioma, and 1 adenocarcinoma. The histopathological analysis confirmed the presence of detrusor muscle layer and accurate diagnosis and staging in all cases (100%). There were no perioperative Clavien-Dindo > 1 complications, no blood transfusion, and no bladder perforations. The histopathology analysis reveals excellent quality without artifacts of fulguration. CONCLUSION The holmium laser resection followed by morcellation of large bladder tumors is a feasible procedure. No complications occurred in our series of cases and all cases provided excellent material for histopathological analysis. (C) 2022 Elsevier Inc.