To systematically review the safety and efficacy of transurethral resection with thulium laser for non-muscle-Invasive bladder cancer(NMIBC).

Randomized controlled trials(RCT) on transurethral resection with thulium laser for NMIBC were searched in PubMed, EMBASE, Cochrane library, Web of Science, CNKI, Wanfang and VIP databases from inception to Nov. 2019. Two reviewers independently screened literature, assessed quality, extracted data, and then Meta-analysis was performed using software Rev-Man 5.3.

A total of 12 RCTs involving 1273 patients were included. The Meta-analysis showed that compared with electrocautery transurethral resection in treating NMIBC, transurethral resection with thulium laser could obviously shorten operation time (MD=-10.36, 95%CI: -19.28~-1.44, P=0.02), intraoperative hemorrhage (MD=-24.66, 95%CI: -36.63~-12.68, P<0.001), postoperative bladder irrigation time (MD=-30.51, 95%CI: -45.06~-15.95, P<0.001), postoperative catheterization (MD=-2.42, 95%CI: -3.57~-1.27, P<0.001), postoperative hospitalization (MD=-2.32, 95%CI: -3.16~-1.47, P<0.001) and decrease operative complications (RR=0.09, 95%CI: 0.04~0.20, P<0.001). But the one year recurrence rates between two kind sof operations were not statistically different (RR=0.84, 95%CI: 0.62~1.14, P=0.27).

Evidence shows that transurethral resection with thulium laser for NMIBC is better than electrocautery transurethral resection in safety and efficacy. However, more large-scale high-quality studies are warranted to assess these results because the limited quality and quantity of the included studies.