Sun Feng, Han Bangmin, Cui Di, Zhao Fujun, Sun Xiaowen, Zhuo Jian, Jing Yifeng, Liu Haitao, Xia Shujie, Yang Yong, Luo Guangheng, Guo Fengfu
Department of Urology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, No.100, Haining Road, Shanghai, 200080, China.
World J Urol. 2015 Apr;33(4):503-8. doi: 10.1007/s00345-014-1456-5. Epub 2014 Dec 9.
To evaluate the long-term durability and complication rates after thulium laser resection of prostate (TmLRP) through a prospective multiple-center study.
From November 2004 to December 2011, we prospectively studied 2,216 patients with symptomatic benign prostatic hyperplasia (BPH) treated with thulium laser resection of the prostate at four medical centers. Patients were assessed on International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR). Perioperative complications were classified according to the modified Clavien classification system.
Of 2,216 patients treated with TmLRP, 1,353 (61.1 %), 1,129 (50.9 %), 847 (38.2 %), and 541 (24.4 %) patients were followed at 5, 6, 7, and 8 years, respectively. Postoperatively, IPSS, QoL, Qmax, and PVR showed a significant improvement from 3 month after surgery and remained significantly improved during the entire follow-up period (p < 0.01). Minor complications occurred in 526 (23.7 %) of the 2,216 patients (Clavien 1: 21.5 %; Clavien 2: 2.3 %). Major complications requiring re-interventions occurred in 48 (2.2 %) of the 2,216 patients (Clavien 3: 2.2 %). No Clavien 4 or Clavien 5 complication had occurred. Urethral stricture and bladder neck contracture occurred in 2.6 % (58) and 1.6 % (35) patients, respectively. Persistent stress incontinence was found in 0.1 % (2) of the patients. Re-operation as a result of BPH recurrence was required in 1.2 % (27) patients.
Thulium laser resection of the prostate is a safe and effective procedure with excellent durability in the treatment of symptomatic BPH.
通过一项前瞻性多中心研究评估前列腺铥激光切除术（TmLRP）后的长期耐用性和并发症发生率。
2004年11月至2011年12月，我们对四个医疗中心接受前列腺铥激光切除术治疗的2216例有症状良性前列腺增生（BPH）患者进行了前瞻性研究。根据国际前列腺症状评分（IPSS）、生活质量（QoL）、最大尿流率（Qmax）和残余尿量（PVR）对患者进行评估。围手术期并发症根据改良的Clavien分类系统进行分类。
在接受TmLRP治疗的2216例患者中，分别有1353例（61.1%）、1129例（50.9%）、847例（38.2%）和541例（24.4%）患者在5年、6年、7年和8年时接受了随访。术后，IPSS、QoL、Qmax和PVR自术后3个月起显著改善，并在整个随访期间持续显著改善（p<0.01）。2216例患者中有526例（23.7%）发生轻微并发症（Clavien 1级：21.5%；Clavien 2级：2.3%）。2216例患者中有48例（2.2%）发生需要再次干预的严重并发症（Clavien 3级：2.2%）。未发生Clavien 4级或Clavien 5级并发症。尿道狭窄和膀胱颈挛缩分别发生在2.6%（58例）和1.6%（35例）的患者中。0.1%（2例）的患者出现持续性压力性尿失禁。1.2%（27例）的患者因BPH复发需要再次手术。
前列腺铥激光切除术是治疗有症状BPH的一种安全有效的手术，具有出色的耐用性。
