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铥激光前列腺切除术与经尿道前列腺电切术治疗良性前列腺增生的安全性和有效性:一项Meta分析

Safety and Efficacy of Thulium Laser Prostatectomy Versus Transurethral Resection of Prostate for Treatment of Benign Prostate Hyperplasia: A Meta-Analysis.

作者信息

Jiang HongJing, Zhou Yu

机构信息

Department of Urology, Chongqing Dongnan Hospital, Chongqing, China.

出版信息

Low Urin Tract Symptoms. 2016 Sep;8(3):165-70. doi: 10.1111/luts.12092. Epub 2015 Feb 20.

Abstract

OBJECTIVE

The aim of the present study was to objectively evaluate the safety and efficacy of Thulium laser prostatectmy (TmLRP) versus transurethral resection of prostate (TURP) in treating benign prostate hyperplasia (BPH).

METHODS

Online databases such as Cochrane Library, PubMed, Embase, and Chinese biomedicine literature database were searched by randomized control trial (RCT), quasi-randomized control trial (Q-RCT) and case control study (CCSs) about TmLRP versus TURP for the treatment of BPH. After study selection, assessment and data extraction conducted, Meta-analyses were performed by using the RevMan 5.2 software.

RESULTS

Six studies involving 640 patients were included and the results of follow-up time was 1 year. The results of meta-analyses showed that: (i) safety indicators: compared with TURP, TmLRP was associated with less decrease of serum sodium salt, less blood transfusion, shorter catheterization time hospital time and more operation time. No differences were noted in the TUR syndrome, recatheterization rate, transitory urge incontinence, stress incontinence urethral stricture and retrograde ejaculation. (ii) Efficacy indicators (International Prostate Symptom Score [IPSS], post-void residual [PVR], Qmax, quality of life [QoL]): Compared with the baseline, significant improvement in IPSS, QoL, Qmax and PVR were obvious improvement before and after surgery in both groups. There were statistical differences in IPSS at 12 months, QoL at 1, 6 months and Qmax 1, 6 months between the two groups.

CONCLUSIONS

TmLRP is a safe and effective procedure for treatment of benign prostatic hyperplasia. Compared with TURP, TmLRP was not only associated with less decrease of serum sodium salt, less blood transfusion, shorter catheterization time and hospital time, but also may be superior to TURP in efficacy.

摘要

目的

本研究旨在客观评估铥激光前列腺切除术(TmLRP)与经尿道前列腺切除术(TURP)治疗良性前列腺增生(BPH)的安全性和有效性。

方法

通过随机对照试验(RCT)、半随机对照试验(Q-RCT)和病例对照研究(CCS),检索Cochrane图书馆、PubMed、Embase和中国生物医学文献数据库等在线数据库中关于TmLRP与TURP治疗BPH的研究。在进行研究筛选、评估和数据提取后,使用RevMan 5.2软件进行Meta分析。

结果

纳入6项研究,共640例患者,随访时间为1年。Meta分析结果显示:(i)安全性指标:与TURP相比,TmLRP导致血清钠盐降低更少、输血更少、导尿时间和住院时间更短,但手术时间更长。在TUR综合征、再次导尿率、暂时性急迫性尿失禁、压力性尿失禁、尿道狭窄和逆行射精方面未观察到差异。(ii)有效性指标(国际前列腺症状评分[IPSS]、残余尿量[PVR]、最大尿流率[Qmax]、生活质量[QoL]):与基线相比,两组手术前后IPSS、QoL、Qmax和PVR均有显著改善。两组在12个月时的IPSS、1个月和6个月时的QoL以及1个月和6个月时的Qmax存在统计学差异。

结论

TmLRP是治疗良性前列腺增生的一种安全有效的方法。与TURP相比,TmLRP不仅血清钠盐降低更少、输血更少、导尿时间和住院时间更短,而且在疗效上可能优于TURP。

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