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A systematic search of PubMed, Embase, Web of Science, and Cochrane Library identified comparative studies, analyzing perioperative complications, oncological outcomes, and surgical quality with heterogeneity assessment (I², subgroup analysis) and risk of bias (ROB2) plus evidence certainty grading (GRADEpro GDT). Fourteen studies with 2,934 patients showed shorter catheterization, irrigation, and hospitalization times, improved safety, and better recurrence-free rates at 3 and 12 months.",{"@graph":14,"@context":76},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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clinical question does the meta-analysis address?","Question",{"text":62,"@type":63},"It compares perioperative safety, surgical quality, and oncological outcomes of thulium laser en bloc resection (TmL-ERBT) versus conventional TURBT in non-muscle-invasive bladder cancer.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How many studies and patients were included, and how were they distributed?",{"text":67,"@type":63},"Fourteen studies were included, totaling 2,934 patients: 1,395 received TmL-ERBT and 1,539 received TURBT.",{"name":69,"@type":60,"acceptedAnswer":70},"Which perioperative outcomes favored TmL-ERBT?",{"text":71,"@type":63},"TmL-ERBT shortened catheterization time, postoperative irrigation time, and hospitalization time, and improved safety indicators such as obturator nerve reflex, bladder perforation, and bleeding.",{"name":73,"@type":60,"acceptedAnswer":74},"Did TmL-ERBT improve recurrence-free rates, and for which follow-up durations?",{"text":75,"@type":63},"Recurrence-free rates were significantly better at 3 months and 12 months, while no significant differences were reported at 24 months and at follow-up of 30 months or more.","https://schema.org",{"og:url":32,"og:type":78,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":80,"canonical":32},"index,follow",{"doc_id":82,"site_id":7},345041,1790150197,{"code":4,"msg":85,"data":86},"success",[87,91,95,99,104,109,114,118,123,126,130],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Story & 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\n[https://doi.org/10.1007/s10103-026-04856-x](https://doi.org/10.1007/s10103-026-04856-x)  \nRESEARCH  \nPerioperative and oncological outcomes of thulium laser-ERBT versus conventional TURBT in non-muscle invasive bladder cancer: a metaanalysis of 2,934 patients  \nDong Chen1 · Zhongbao Zhou2 · Guangzhu Wei1 · Fengbo Zhang1  \nReceived: 9 November 2025 / Accepted: 8 March 2026 © The Author(s) 2026  \nAbstract  \nThulium laser en bloc resection of bladder tumors (TmL-ERBT) represents a novel surgical approach for non-muscleinvasive bladder cancer (NMIBC), but its comparative advantages over conventional transurethral resection (TURBT) remain controversial. This meta-analysis aimed to evaluate perioperative safety, surgical quality, and oncological outcomesofTmL-ERBT versus TURBT. A systematic search of PubMed, Embase, Web of Science, and Cochrane Library identified comparative studies ofTmL-ERBT versus TURBT. Perioperative complications, oncological outcomes, and surgical quality indicators were analyzed. Heterogeneity was assessed using I² statistics and subgroup analysis. The study quality was evaluated using the ROB2 tool. Evidence certainty was graded using the GRADEpro GDT. Fourteen studies comprising 2,934 patients (TmL-ERBT: n = 1,395; TURBT: n = 1,539) were included. TmL-ERBT demonstrated significant advantagesin perioperative outcomes: shorter catheterization time (MD: -0.71 days, P = 0.001), reduced postoperative irrigation time (MD: -8.79 h, P = 0.0004), and decreased hospitalization time (MD: -0.63 days, P = 0.006) . Operation duration showed no significant difference (MD: -2.66 min, P = 0.33) . Safety outcomes favored TmL-ERBT with virtual elimination of obturator nerve reflex (OR: 0.04, P \u003C 0.00001), reduced bladder perforation (OR: 0.26, P \u003C 0.00001), decreased bleeding (OR: 0.10, P \u003C 0.0001), and improved detrusor muscle presence (OR: 3.22, P = 0.03) . Overall complication rates were comparable (OR: 0.75, P = 0.28) . TmL-ERBT significantly improved recurrence-free rates at 3 months (OR: 1.70, P = 0.02) and 12 months (OR: 1.45, P = 0.04), but no difference at 24 months (OR: 1.03, P = 0.82) and ≥ 30 months (OR: 0.85, P = 0.13) than TURBT. Subgroup analyses revealed the advantages of TmL-ERBT were most pronounced in low-risk, smaller, solitary tumors. TmL-ERBT demonstrated superior perioperative outcomes, enhanced safety with reduced complications compared with conventional TURBT. These findings supported TmL-ERBT as a promising alternative for NMIBC management.  \nKeywords Thulium laser · Non-muscle-invasive bladder cancer · En bloc resection · Perioperative outcomes · Recurrence-free rate  \n􀀍 Fengbo Zhang [drzhangfb@163.com](drzhangfb@163.com)  \nDong Chen  \n[15001368088@163.com](15001368088@163.com)  \nZhongbao Zhou  \n[346894383@qq.com](346894383@qq.com)  \nGuangzhu Wei  \n[doctorwgz@126.com](doctorwgz@126.com)  \n1 Department of Urology, Beijing Luhe Hospital, Capital Medical University, Beijing, China  \n2 Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China  \nIntroduction  \nBladder cancer ranks among the most prevalent malignancies ofthe urinary system worldwide, and non-muscle-invasive bladder cancer (NMIBC) accounts for approximately 75–80% of newly diagnosed bladder cancer [1] . Transurethral resection of bladder tumor (TURBT) has served asthe gold standard for diagnosis and treatment of NMIBC [2] . However, conventional TURBT has limitations, including fragmented resection, thermal artifacts, and inadequate detrusor muscle sampling, potentially leading to understaging and compromising pathological assessment [3, 4] . Perioperative complications such as bladder perforation,  \n1 3  \nobturator nerve reflex, and irrigation-related issues are concerns [5] . Most critically, incomplete resection and tumor cell reimplantation during the procedure may contribute to the high recurrence rates [6] . Beyond surgical improvements, the landscape of NMIB","cbCainDiMH4Ywggv","https://ap.wps.com/l/cbCainDiMH4Ywggv","pdf",1036405,13,"English","# Abstract","[{\"question\":\"What clinical question does the meta-analysis address?\",\"answer\":\"It compares perioperative safety, surgical quality, and oncological outcomes of thulium laser en bloc resection (TmL-ERBT) versus conventional TURBT in non-muscle-invasive bladder cancer.\"},{\"question\":\"How many studies and patients were included, and how were they distributed?\",\"answer\":\"Fourteen studies were included, totaling 2,934 patients: 1,395 received TmL-ERBT and 1,539 received TURBT.\"},{\"question\":\"Which perioperative outcomes favored TmL-ERBT?\",\"answer\":\"TmL-ERBT shortened catheterization time, postoperative irrigation time, and hospitalization time, and improved safety indicators such as obturator nerve reflex, bladder perforation, and bleeding.\"},{\"question\":\"Did TmL-ERBT improve recurrence-free rates, and for which follow-up durations?\",\"answer\":\"Recurrence-free rates were significantly better at 3 months and 12 months, while no significant differences were reported at 24 months and at follow-up of 30 months or more.\"}]","Perioperative and oncological outcomes of thulium laser-ERBT versus conventional TURBT in non-muscle invasive bladder cancer: a metaanalysis of 2,934 patients | PDF",1790056332,33]