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基于初步经验的经尿道前列腺电切术(TUR-P)与钬激光前列腺剜除术(HoLEP)临床结果比较

[Comparison of clinical results between TUR-P and holmium laser enucleation of the prostate (HoLEP) based on the initial experience].

作者信息

Shishido Toshihide, Enomoto Kaori, Fujita Naoyuki, Suzuki Atsushi, Hayashi Kenjiro, Nomura Masafumi, Itaya Naoshi, Tanbo Mitsuhiro, Watanabe Kazuyoshi, Noda Haruhisa, Okegawa Takatsugu, Nutahara Kikuo, Higashihara Eiji

机构信息

Department of Urology, Kyorin University School of Medicine.

出版信息

Nihon Hinyokika Gakkai Zasshi. 2008 Mar;99(3):543-50. doi: 10.5980/jpnjurol1989.99.543.

DOI:10.5980/jpnjurol1989.99.543
PMID:18404883
Abstract

OBJECTIVE

We compared the surgical results between holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TUR-P) for the treatment of men with benign prostatic hyperplasia (BPH).

METHODS

A total of 87 patients with symptomatic BPH were analysed. HoLEP was performed on 46 men (mean age 68.2 +/- 7.5 years old) from December 2005 to February 2007, and TUR-P was performed on 41 men (mean age 69.2 +/- 7.3 years old) from April 2004 to March 2006.

RESULTS

Both groups were comparable in terms of age, pre-operative IPSS, QOL index, urodynamic study results and prostate volume. During operation, decrease in hemoglobin was less in the HoLEP group than in the TUR-P group (1.15 +/- 1.2 vs 1.91 +/- 1.3 g/dl p < 0.05). The operation time was significantly longer in the HoLEP group than in the TUR-P group (161.9 +/- 65.0 vs. 118.3 +/- 36.9 minutes p < 0.001). Mean resected weight was 29.3 +/- 13.3 g (10-55) in the TUR-P group and 34.8 +/- 33.4 g (5-148) in the HoLEP group (p = 0.337). The catheterization period (52.1 +/- 29.6 vs. 115.2 +/- 27.5 hour p < 0.001) and hospital stay (6.6 +/- 2.3 vs. 9.4 +/- 2.2 days p < 0.001) were significantly shorter in the HoLEP group than in the TUR-P group. At follow up, Qmax, average flow rate and post void residual urine (PVR) in two groups improved significantly, and these parameters were not significantly different between the groups after 3 months.

CONCLUSIONS

Both TUR-P and HoLEP were effective in relieving BOO. The estimated blood loss, a catheterization time and hospitalization were less or shorter in the HoLEP group. HoLEP may be a good alternative to the conventional transurethral electrocautery resection of the prostate for symptomatic BPH.

摘要

目的

我们比较了钬激光前列腺剜除术(HoLEP)和经尿道前列腺电切术(TUR-P)治疗良性前列腺增生(BPH)男性患者的手术结果。

方法

共分析了87例有症状的BPH患者。2005年12月至2007年2月,对46例男性(平均年龄68.2±7.5岁)实施了HoLEP;2004年4月至2006年3月,对41例男性(平均年龄69.2±7.3岁)实施了TUR-P。

结果

两组在年龄、术前国际前列腺症状评分(IPSS)、生活质量指数、尿动力学研究结果和前列腺体积方面具有可比性。手术过程中,HoLEP组血红蛋白下降幅度小于TUR-P组(1.15±1.2 vs 1.91±1.3 g/dl,p<0.05)。HoLEP组手术时间显著长于TUR-P组(161.9±65.0 vs. 118.3±36.9分钟,p<0.001)。TUR-P组平均切除重量为29.3±13.3 g(10 - 55),HoLEP组为34.8±33.4 g(5 - 148)(p = 0.337)。HoLEP组导尿时间(52.1±29.6 vs. 115.2±27.5小时,p<0.001)和住院时间(6.6±2.3 vs. 9.4±2.2天,p<0.001)显著短于TUR-P组。随访时,两组的最大尿流率(Qmax)、平均尿流率和残余尿量(PVR)均显著改善,3个月后两组这些参数无显著差异。

结论

TUR-P和HoLEP在缓解膀胱出口梗阻(BOO)方面均有效。HoLEP组估计失血量、导尿时间和住院时间更少或更短。对于有症状的BPH,HoLEP可能是传统经尿道前列腺电切术的良好替代方法。

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引用本文的文献

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HoLEP has come of age.经尿道前列腺剜除术已成熟。
World J Urol. 2015 Apr;33(4):487-93. doi: 10.1007/s00345-014-1443-x. Epub 2014 Nov 22.
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TURP for BPH. How large is too large?经尿道前列腺切除术治疗良性前列腺增生。多大算太大?
J Med Life. 2010 Oct-Dec;3(4):376-80.
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TURIS plasma vaporization--initial Romanian experience with a new technology.经尿道选择性绿激光汽化术——罗马尼亚对一项新技术的初步经验
J Med Life. 2009 Jul-Sep;2(3):325-32.
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