Zhang Mimi W, El Tayeb Marawan M, Borofsky Michael S, Dauw Casey A, Wagner Kristofer R, Lowry Patrick S, Bird Erin T, Hudson Tillman C, Lingeman James E
1 Department of Urology, Indiana University School of Medicine , Indianapolis, Indiana.
2 Department of Urology, Baylor Scott and White Health , Temple, Texas.
J Endourol. 2017 Sep;31(9):847-850. doi: 10.1089/end.2017.0095. Epub 2017 Jul 19.
To compare perioperative outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) and robotic-assisted simple prostatectomy (RSP) for benign prostatic hypertrophy (BPH).
Patient demographics and perioperative outcomes were compared between 600 patients undergoing HoLEP and 32 patients undergoing RSP at two separate academic institutions between 2008 and 2015.
Patients undergoing HoLEP and RSP had comparable ages (71 vs 71, p = 0.96) and baseline American Urological Association Symptom Scores (20 vs 24, p = 0.21). There was no difference in mean specimen weight (96 g vs 110 g, p = 0.15). Mean operative time was reduced in the HoLEP cohort (103 minutes vs 274 minutes, p < 0.001). Patients undergoing HoLEP had lesser decreases in hemoglobin, decreased transfusions rates, shorter hospital stays, and decreased mean duration of catheterization. There was no difference in the rate of complications Clavien grade 3 or greater (p = 0.33).
HoLEP and RSP are both efficacious treatments for large gland BPH. In expert hands, HoLEP appears to have a favorable perioperative profile. Further studies are necessary to compare long-term efficacy, cost, and learning curve influences, especially as minimally invasive approaches become more widespread.
比较接受钬激光前列腺剜除术（HoLEP）和机器人辅助单纯前列腺切除术（RSP）治疗良性前列腺增生（BPH）患者的围手术期结果。
比较2008年至2015年期间在两个不同学术机构接受HoLEP的600例患者和接受RSP的32例患者的人口统计学资料和围手术期结果。
接受HoLEP和RSP的患者年龄相当（71岁对71岁，p = 0.96），美国泌尿外科协会症状评分基线相当（20分对24分，p = 0.21）。平均标本重量无差异（96克对110克，p = 0.15）。HoLEP组的平均手术时间缩短（103分钟对274分钟，p < 0.001）。接受HoLEP的患者血红蛋白下降较少，输血率降低，住院时间缩短，导尿管留置平均时间缩短。Clavien 3级及以上并发症发生率无差异（p = 0.33）。
HoLEP和RSP都是治疗大腺体BPH的有效方法。在专家手中，HoLEP似乎具有良好的围手术期表现。需要进一步研究以比较长期疗效、成本和学习曲线影响，特别是随着微创方法越来越普遍。
