Photodynamic Diagnosis–guided Dual Laser Ablation for Upper Urinary Tract Carcinoma: Preoperative Preparation, Surgical Technique, and Clinical Outcomes

摘要: Abstract Background Although ureteroscopic surgery (URS) is beneficial for low-risk upper urinary tract carcinoma (UTUC), there no standardized URS technique or navigation system challenging cases. Objective To present a UTUC using thulium (Tm):YAG and holmium (Ho):YAG lasers under photodynamic diagnosis (PDD) guidance, named PDD-guided dual laser ablation (PDD-DLA) compare its efficacy with that of conventional Ho:YAG (HLA; historical control). Design, setting, participants The study included ten consecutive patients who underwent PDD-DLA between 2017 2019. control group comprised 16 HLA 2006 2016. Surgical procedure After oral administration 5-aminolevulinic acid (20 mg/kg), tumors were endoscopically resected via PDD-DLA. Measurements Clinical data prospectively collected our institutional set. Disease progression, recurrence, clinical outcomes assessed. Results limitations was successfully performed in all patients. median tumor size 23.5 mm (interquartile range [IQR] 12.8–30.0) four cases (40.0%) high-grade tumor. operative time 120 min (IQR 98.5–142.5). No Clavien-Dindo grade ≥3 complications observed. There differences most characteristics the groups. 2-yr progression-free survival rate 100% 58.7% (p = 0.0197), recurrence-free 57.1% 41.3%, respectively (p = 0.072). had lower incidence salvage RNU compared (0.0% vs 50%; p = 0.009). small sample might affect reproducibility these results. Conclusions seems to be an effective feasible endoscopic treatment favorable oncological outcomes. Patient summary We investigated new treating cancer called diagnosis–guided ablation. Our strategy removing stopping bleeding. Further studies larger groups are needed confirm whether this improves