Hong Kai, Liu Yu-Qing, Lu Jian, Xiao Chun-Lei, Huang Yi, Ma Lu-Lin
Department of Urology, Peking University Third Hospital, Beijing 100191, China.
Chin Med J (Engl). 2015 Apr 5;128(7):884-9. doi: 10.4103/0366-6999.154282.
This study compared the efficacy and safety between 120-W thulium:yttrium-aluminum-garnet (Tm:YAG) vapoenucleation of prostates (ThuVEP) and holmium laser enucleation of prostates (HoLEP) for patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).
A retrospective analysis of 88 consecutive patients with symptomatic BPH was carried out, who underwent either 120-W ThuVEP or HoLEP nonrandomly. Patient demographics and peri-operative and 12-month follow-up data were analyzed with the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum flow rate (Qmax), postvoid residual urine volume (PVR), and rates of peri-operative and late complications.
The patients in each group showed no significant difference in preoperative parameters. Compared with the HoLEP group, patients in the 120-W ThuVEP group required significantly shorter time for laser enucleation (58.3 ± 12.8 min vs. 70.5 ± 22.3 min, P = 0.003), and resulted in a significant superiority in laser efficiency (resected prostate weight/laser enucleation time) for 120-W Tm:YAG laser compared to holmium:YAG laser (0.69 ± 0.18 vs. 0.61 ± 0.19, P = 0.048). During 1, 6, and 12 months of follow-ups, the procedures did not demonstrate a significant difference in IPSS, QoL score, Qmax, or PVR (P > 0.05). Mean peri-operative decrease of hemoglobin in the HoLEP group was similar to the ThuVEP group (17.1 ± 12.0 g/L vs. 15.2 ± 10.1 g/L, P = 0.415). Early and late incidences of complications were low and did not differ significantly between the two groups of 120-W ThuVEP and HoLEP patients (P > 0.05).
120-W ThuVEP and HoLEP are potent, safe and efficient modalities of minimally invasive surgeries for patients with LUTS due to BPH. Compared with HoLEP, 120-W ThuVEP offers advantages of reduction of laser enucleation time and improvement of laser efficiency.
本研究比较了120瓦掺铥钇铝石榴石（Tm:YAG）前列腺汽化剜除术（ThuVEP）与钬激光前列腺剜除术（HoLEP）治疗良性前列腺增生（BPH）所致下尿路症状（LUTS）患者的疗效和安全性。
对88例有症状的BPH患者进行回顾性分析，这些患者非随机接受了120瓦ThuVEP或HoLEP治疗。采用国际前列腺症状评分（IPSS）、生活质量（QoL）评分、最大尿流率（Qmax）、残余尿量（PVR）以及围手术期和晚期并发症发生率对患者的人口统计学数据、围手术期数据和12个月的随访数据进行分析。
每组患者术前参数无显著差异。与HoLEP组相比，120瓦ThuVEP组患者的激光剜除时间显著缩短（58.3±12.8分钟对70.5±22.3分钟，P = 0.003），并且120瓦Tm:YAG激光的激光效率（切除前列腺重量/激光剜除时间）显著优于钬激光（0.69±0.18对0.61±0.19，P = 0.048）。在1、6和12个月的随访期间，两种手术在IPSS、QoL评分、Qmax或PVR方面无显著差异（P>0.05）。HoLEP组围手术期血红蛋白平均下降幅度与ThuVEP组相似（17.1±12.0克/升对15.2±10.1克/升，P = 0.415）。两组120瓦ThuVEP和HoLEP患者的早期和晚期并发症发生率均较低，且无显著差异（P>0.05）。
120瓦ThuVEP和HoLEP是治疗BPH所致LUTS患者的有效、安全且高效的微创手术方式。与HoLEP相比，120瓦ThuVEP具有缩短激光剜除时间和提高激光效率的优势。
