比较180W XPS激光和120W HPS激光前列腺光汽化术的队列研究。

Cohort study comparing prostate photovaporisation with XPS 180W and HPS 120W laser.

作者信息

López B, Capitán C, Hernández V, de la Peña E, Jiménez-Valladolid I, Guijarro A, Pérez-Fernández E, Llorente C

机构信息

Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España.

出版信息

Actas Urol Esp. 2016 Jan-Feb;40(1):49-54. doi: 10.1016/j.acuro.2015.07.002. Epub 2015 Aug 29.

DOI:10.1016/j.acuro.2015.07.002

PMID:26323662

Abstract

INTRODUCTION AND OBJECTIVE

Prostate photovaporisation with Greenlight laser for the surgical treatment of benign prostate hyperplasia has rapidly evolve to the new XPS 180W. We have previously demonstrated the safety and efficacy of the HPS 120W. The aim of this study was to assess the functional and safety results, with a year of follow-up, of photovaporisation using the XPS 180W laser compared with its predecessor.

MATERIAL AND METHODS

A cohort study was conducted with a series of 191 consecutive patients who underwent photovaporisation between 1/2008 and 5/2013. The inclusion criteria were an international prostate symptom score (IPSS) >15 after medical failure, a prostate volume <80 cm(3) and a maximum flow <15 mL/s. We assessed preoperative and intraoperative variables (energy used, laser time and total surgical time), complications, catheter hours, length of stay and functional results (maximum flow, IPSS, prostate-specific antigen and prostate volume) at 3, 6 and 12 months. We analysed the homogeneity in preoperative characteristics of the 2 groups through univariate analysis techniques. The postoperative functional results were assessed through an analysis of variance of repeated measures with mixed models.

RESULTS

A total of 109 (57.1%) procedures were performed using HPS 120W, and 82 (42.9%) were performed using XPS. There were no differences between the preoperative characteristics. We observed significant differences both in the surgical time and effective laser time in favour of the XPS system. This advantage was 11% (48 ± 15.7 vs. 53.8 ± 16.2, p<.05) and 9% (32.8 ± 11.7 vs. 36 ± 11.6, p<.05), respectively. There were no statistically significant differences in the rest of the analysed parameters.

CONCLUSION

The technical improvements in the XPS 180W system help reduce surgical time, maintaining the safety and efficacy profile offered by the HPS 120W system, with completely superimposable results at 1 year of follow-up.

摘要

引言与目的

用于良性前列腺增生手术治疗的绿激光前列腺汽化术已迅速发展至新型的XPS 180W。我们之前已证明HPS 120W的安全性和有效性。本研究的目的是评估使用XPS 180W激光进行汽化术并随访一年后的功能及安全结果，并与之前的型号进行比较。

材料与方法

进行一项队列研究，纳入2008年1月至2013年5月期间连续接受汽化术的191例患者。纳入标准为药物治疗失败后国际前列腺症状评分（IPSS）>15、前列腺体积<80 cm³且最大尿流率<15 mL/s。我们评估了术前和术中变量（使用的能量、激光时间和总手术时间）、并发症、导尿管留置时间、住院时间以及3个月、6个月和12个月时的功能结果（最大尿流率、IPSS、前列腺特异性抗原和前列腺体积）。我们通过单因素分析技术分析了两组术前特征的同质性。术后功能结果通过混合模型重复测量方差分析进行评估。

结果

共使用HPS 120W进行了109例（57.1%）手术，使用XPS进行了82例（42.9%）手术。术前特征无差异。我们观察到手术时间和有效激光时间均存在显著差异，XPS系统更具优势。这一优势分别为11%（48±15.7对53.8±16.2，p<0.05）和9%（32.8±11.7对36±11.6，p<0.05）。其余分析参数无统计学显著差异。