Wang Li, Yu Qiu-Yan, Liu Yan, Zhu Zhen-Li, Huang Yuan-Wei, Li Ke
Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China E-mail :
Asian Pac J Cancer Prev. 2016;17(9):4281-4288.
Traditional meta-analyses or systematic reviews of randomized controlled trials (RCTs) have been used to compare laser surgeries and transurethral resection of the prostate (TURP) for benign prostate hyperplasia (BHP), but they cannot provide a hierarchy regarding efficacy and safety of treatment.
We therefore performed a network meta-analysis (NMA) to compare and create hierarchies for efficacy and safety of TUPR and laser surgeries for BPH.
We searched for reports of RCTs published up to April 25, 2015. After methodological quality assessment and data extraction, we performed an NMA to compare TURP and laser surgeries for BPH.
We ranked the treatments of TURP and laser surgeries for BPH. For IPSS at 6 months, holmium laser resection of the prostate (HoLRP) ranked the first-best and at 12 months, holmium laser enucleation of the prostate (HoLEP). For Qmax at 6 and 12 months, HoLEP ranked the first-best; for operative time it was TURP; for cathedral removal time, diode laser enucleation of the prostate (DiLEP) ranked the first-best.
Although TURP is considered the gold standard for treating BPH, it is not better in terms of efficacy and safety compared with the laser surgery. Our NMA created hierarchies for the 9 types of surgery in terms of efficacy and safety, which should help clinicians choose the best approach for the individual patient.
传统的随机对照试验（RCT）的荟萃分析或系统评价已被用于比较激光手术和经尿道前列腺切除术（TURP）治疗良性前列腺增生（BPH），但它们无法提供治疗效果和安全性的等级排序。
因此，我们进行了一项网状荟萃分析（NMA），以比较TUPR和激光手术治疗BPH的疗效和安全性，并创建等级排序。
我们检索了截至2015年4月25日发表的RCT报告。在进行方法学质量评估和数据提取后，我们进行了NMA以比较TURP和激光手术治疗BPH的效果。
我们对TURP和激光手术治疗BPH的方法进行了排序。对于6个月时的国际前列腺症状评分（IPSS），钬激光前列腺切除术（HoLRP）排名第一；对于12个月时的评分，钬激光前列腺剜除术（HoLEP）排名第一。对于6个月和12个月时的最大尿流率（Qmax），HoLEP排名第一；对于手术时间，TURP最短；对于腺体切除时间，二极管激光前列腺剜除术（DiLEP）排名第一。
尽管TURP被认为是治疗BPH的金标准，但在疗效和安全性方面并不优于激光手术。我们的NMA在疗效和安全性方面为9种手术方式创建了等级排序，这应有助于临床医生为个体患者选择最佳治疗方法。
