Holmium LASER enbloc Transurethral Resection of Bladder Tumor (HoL-ERBT) Vs Conventional Transurethral Resection of Bladder Tumor (cTURBT) for primary bladder tumors: Randomized controlled trial.

With the ubiquitous availability of Holmium LASER major centers started using holmium LASER as energy source for resection in ERBT (HoL-ERBT). The current available literature says that HoL-ERBT represents an improvement in the surgical management of bladder tumor. The resection is more precise and complete compared to cTURBT. However, the limitations were large tumors, difficult locations and methods of retrieval.  Moreover, the quality of an en-bloc specimen, including the tumor with its adjacent bladder wall layers, allows an accurate pathological review which leads to correct risk allocation and therapy. In comparison to cTURBT, HoL-ERBT has advantages in reducing irrigation time and avoiding bladder perforation, although it may require a longer operating time; no benefit in terms of recurrence rates has been demonstrated. However limited RCTs are available and inclusion criteria are narrow on this topic.

 Our randomized controlled trial (RCT) aims to evaluate the feasibility, histopathological benefits, and clinical outcomes of HoL-ERBT compared to cTURBT. This study seeks to address existing gaps in research and provide valuable insights into the optimal surgical management of bladder tumors.