Mathieu R, Lebdai S, Cornu J N, Benchikh A, Azzouzi A R, Delongchamps N B, Dumonceau O, Faix A, Fourmarier M, Haillot O, Lukacs B, Misrai V, de La Taille A, Robert G, Descazeaud A
Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-Le-Guillou, 35000 Rennes, France.
Service d'urologie, CHU d'Angers, 49933 Angers, France.
Prog Urol. 2017 May;27(6):362-368. doi: 10.1016/j.purol.2017.03.010. Epub 2017 May 8.
To evaluate perioperative cost related to surgical treatments of benign prostatic obstruction (BPO): photoselective vaporization of the prostate (pvp), holmium/thullium laser enucleation (HoLEP/ThuLEP), transurethral resection of the prostate (TURP) and open prostatectomy (OP).
We retrospectively collected data from 237 patients who consecutively underwent a surgical treatment for BPH between January 2012 and June 2013 at nine institutions in France. An economic simulation model was constructed to estimate the cost of hospitalization related to surgical procedure from the hospital perspective and a cost minimization analysis was performed.
TURP, OP, HoLEP/ThuLEP and PVP were performed in 99 (42%), 23 (10%), 64 (27%) and 51 (21%) patients, respectively. For men with prostate size<80mL: mean operative time was shorter with mTURP and PVP than HoLEP/thuLEP (P<0.001); Mean postoperative length of stay were 1.9, 3 vs. 3.4 days, for HoLEP/Thulep, PVP and TURP respectively (P=0.006); Costs of first hospitalization were comparable between HoLEP/ThuLEP and TURP but higher with PVP (P<0.001). For men with prostate size≥80mL: Compared to PVP and HoLEP/ThuLEP, OP was associated with shorter operative time (P<0.001) but longer length of stay (2.4, 4.2 vs. 7.8 days, respectively, P<0.0001); Costs of first hospitalization were significantly higher with OP than HoLEP/ThuLEP or PVP (P<0.001).
PVP and HoLEP/ThuLEP were associated with a shorter LOS than TURP and OP. This benefit suggests these procedures could be more cost effective than OP, but still not cheaper alternatives to TURP.
评估与良性前列腺梗阻（BPO）手术治疗相关的围手术期成本：前列腺光选择性汽化术（PVP）、钬/铥激光剜除术（HoLEP/ThuLEP）、经尿道前列腺切除术（TURP）和开放性前列腺切除术（OP）。
我们回顾性收集了2012年1月至2013年6月期间在法国9家机构连续接受BPH手术治疗的237例患者的数据。构建了一个经济模拟模型，从医院角度估计与手术相关的住院成本，并进行了成本最小化分析。
分别有99例（42%）、23例（10%）、64例（27%）和51例（21%）患者接受了TURP、OP、HoLEP/ThuLEP和PVP手术。对于前列腺体积<80mL的男性：mTURP和PVP的平均手术时间比HoLEP/thuLEP短（P<0.001）；HoLEP/Thulep、PVP和TURP的术后平均住院天数分别为1.9天、3天和3.4天（P=0.006）；HoLEP/ThuLEP和TURP首次住院成本相当，但PVP更高（P<0.001）。对于前列腺体积≥80mL的男性：与PVP和HoLEP/ThuLEP相比，OP的手术时间较短（P<0.001），但住院时间较长（分别为2.4天、4.2天和7.8天，P<0.0001）；OP的首次住院成本显著高于HoLEP/ThuLEP或PVP（P<0.001）。
PVP和HoLEP/ThuLEP的住院时间比TURP和OP短。这一优势表明这些手术可能比OP更具成本效益，但仍不是比TURP更便宜的替代方案。
5级。
