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绿光激光前列腺选择性光汽化术与经尿道前列腺电切术治疗良性前列腺增生症的系统评价和荟萃分析。

Photoselective vaporization with the green light laser vs transurethral resection of the prostate for treating benign prostate hyperplasia: a systematic review and meta-analysis.

机构信息

Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.

出版信息

BJU Int. 2013 Feb;111(2):312-23. doi: 10.1111/j.1464-410X.2012.11395.x. Epub 2012 Nov 13.

Abstract

OBJECTIVE

To assess the overall efficacy and safety of photoselective vaporization of the prostate (PVP) vs transurethral resection of the prostate (TURP) for treating patients with lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH).

PATIENTS AND METHODS

A systematic search of the electronic databases, including MEDLINE, Embase, Web of Science and The Cochrane Library, as well as manual bibliography searches were performed. The pooled estimates of maximum flow rate (Q(max)), postvoid residual (PVR), quality of life (QoL), International Prostate Symptom Score (IPSS), operation duration, blood loss, catheterization time, hospital stay, capsule perforation, transfusion, transurethral resection (TUR) syndrome, urethral stricture and reintervention were calculated.

RESULTS

At the 3-month follow-up, there was no significant difference in Q(max), PVR, QoL and IPSS between the TURP and PVP groups. At the 6-month follow-up, the pooled QoL favoured TURP, but there was no significant difference in the other variables between the two groups. PVP was associated with less blood loss, transfusion, capsular perforation, TUR syndrome, shorter catheterization time and hospital stay, but longer operation duration and higher reintervention rate.

CONCLUSIONS

The efficacy of PVP was similar to that of TURP in relation to Q(max), PVR, QoL and IPSS, and it offered several advantages over TURP. As a promising minimal invasive technique, PVP could be used as an alternative surgical procedure for treating BPH.

摘要

目的

评估经尿道前列腺汽化术(PVP)与经尿道前列腺切除术(TURP)治疗良性前列腺增生(BPH)相关下尿路症状(LUTS)患者的总体疗效和安全性。

患者和方法

系统检索电子数据库,包括 MEDLINE、Embase、Web of Science 和 The Cochrane Library,并进行手动参考文献检索。计算最大尿流率(Q(max))、残余尿量(PVR)、生活质量(QoL)、国际前列腺症状评分(IPSS)、手术时间、出血量、导尿时间、住院时间、胶囊穿孔、输血、TUR 综合征、尿道狭窄和再次干预的汇总估计值。

结果

在 3 个月的随访中,TURP 和 PVP 组之间 Q(max)、PVR、QoL 和 IPSS 无显著差异。在 6 个月的随访中,TURP 组的 QoL 更优,但两组间其他变量无显著差异。PVP 组出血量、输血、胶囊穿孔、TUR 综合征、导尿时间和住院时间较短,但手术时间较长,再次干预率较高。

结论

PVP 的疗效与 TURP 相似,在 Q(max)、PVR、QoL 和 IPSS 方面,PVP 比 TURP 具有更多优势。作为一种有前途的微创技术,PVP 可作为治疗 BPH 的替代手术方法。

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