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绿光120瓦激光选择性汽化前列腺与经尿道前列腺切除术治疗良性前列腺增生的比较:一项随机对照试验的系统评价与荟萃分析

Photoselective vaporization of the prostate with GreenLight 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis of randomized controlled trials.

作者信息

Zang Ya-Chen, Deng Xin-Xi, Yang Dong-Rong, Xue Bo-Xin, Xu Li-Jun, Liu Xiao-Long, Zhou Yi-Bin, Shan Yu-Xi

机构信息

Department of Urology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, Jiangsu Province, People's of Republic China.

Department of Urology, JiuJiang No.1 People's Hospital, No.48, South Road of Taling, Jiujiang, 332000, Jiangxi Province, People's of Republic China.

出版信息

Lasers Med Sci. 2016 Feb;31(2):235-40. doi: 10.1007/s10103-015-1843-1. Epub 2015 Dec 28.

Abstract

The aim of this study is to assess the overall efficacy and safety of photoselective vaporization of the prostate (PVP) with GreenLight 120-W laser versus transurethral resection of the prostate (TURP) for treating patients of benign prostate hyperplasia (BPH) with lower urinary tract symptoms (LUTS). We performed a literature search of The Cochrane Library and the electronic databases, including Embase, Medline, and Web of Science. Manual searches were conducted of the conference proceedings, including European Association of Urology and American Urological Association (2007 to 2012). Outcomes reviewed included clinical baseline characteristics, perioperative data, complications, and postoperative functional results, such as postvoid residual (PVR), international prostate symptom score (IPSS), quality of life (QoL), and maximum flow rate (Qmax). Six randomized controlled trials (RCTs) were enrolled. Three hundred and forty-seven patients undergone 120-W PVP, and 350 patients were treated with TURP in the RCTs. There were no significant differences for clinical characteristics in these trials. In perioperative data, catheterization time and length of hospital stay were shorter in the PVP group. However, the operation time was shorter in the TURP group. Capsular perforation, blood transfusion, clot retention, and macroscopic hematuria were markedly less likely in PVP-treated subjects. The other complications between PVP and TURP did not demonstrate a statistic difference. There were no significant differences in QoL, PVR, IPSS, and Qmax in the 1, 3, 6, 12, and 24 months of postoperative follow-up. There was no significant difference at postoperation follow-up of functional outcomes including IPSS, PVR, Qmax, and QoL between the TURP-treated subjects and PVP-treated subjects. Owing to a shorter catheterization time, reduced hospital duration and less complication, PVP could be used as an alternative and a promising minimal invasive surgical procedure for the treatment of BPH.

摘要

本研究旨在评估采用120瓦绿激光进行前列腺光选择性汽化术(PVP)与经尿道前列腺切除术(TURP)治疗有下尿路症状(LUTS)的良性前列腺增生(BPH)患者的总体疗效和安全性。我们检索了Cochrane图书馆以及包括Embase、Medline和Web of Science在内的电子数据库。对手工检索会议论文集,包括欧洲泌尿外科学会和美国泌尿外科学会(2007年至2012年)。回顾的结果包括临床基线特征、围手术期数据、并发症以及术后功能结果,如残余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量(QoL)和最大尿流率(Qmax)。纳入了六项随机对照试验(RCT)。在这些试验中,347例患者接受了120瓦PVP治疗,350例患者接受了TURP治疗。这些试验中的临床特征无显著差异。在围手术期数据方面,PVP组的导尿时间和住院时间较短。然而,TURP组的手术时间较短。PVP治疗的患者发生包膜穿孔、输血、血块残留和肉眼血尿的可能性明显较小。PVP和TURP之间的其他并发症未显示出统计学差异。术后1、3、6、12和24个月的随访中,QoL、PVR、IPSS和Qmax无显著差异。TURP治疗组和PVP治疗组在术后随访的包括IPSS、PVR、Qmax和QoL在内的功能结果方面无显著差异。由于导尿时间较短、住院时间缩短且并发症较少,PVP可作为治疗BPH的一种替代且有前景的微创手术方法。

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