Abstract：Objective: To systematically assess the efficacy and safety of holmium laser (HOLRBt) versus conventional transurethral resection (TURBT) for non muscle invasive bladder cancer (NMIBC). Methods: Randomized controlled trials (RCTs) regarding the efficacy and safety of HOLRBt vs. TURBT for NMIBC were retrieved in PubMed, Cochrane library, Sciverse, CNKI, VIP and Wanfang database from databases establishment to Dec. 2016. According to the including and exclusion criterion, two reviewers independently screened the trials, and the Meta-analysis was done with RevMan 5.3 soft ware. Results: A total of 14 RCTs were eligible for the study, including 1 746 cases. The pooled results showed that HOLRBt group had a less blood loss [MD=-66.00, 95% CI=(80.75, -51.24), P<0.000 01], and lower obturator reflex rate [RR=0.06, 95% CI=(0.02, 0.16), P<0.000 01] and perforation rate [RR=0.15, 95%CI=(0.07, 0.33), P<0.000 01] than TURBT group. However, there was no significant difference in operation time [MD=-0.14, 95% CI=(-3.55, 3.26), P=0.93] between two groups. Meanwhile, the one-year recurrence rate in HOLRBt group was significantly lower than that in TURBT group [RR=0.65, 95% CI=(0.46, 0.91), P=0.01]. There was no significant difference in the 2-year recurrence rate between two groups [RR=0.52, 95% CI=(0.20, 1.37), P=0.19]. Conclusions: Compared with TURBT, HOLRBt had less blood loss and lower obturator reflex rate and perforation rate. Therefore, HOLRBt should be considered as a preferable option for NMIBC.
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