DRG Abacus, Bicester, Oxfordshire, UK.
Olympus KeyMed Group Companies Ltd., Southend-on-Sea, Essex, UK.
Eur Urol Focus. 2018 Mar;4(2):270-279. doi: 10.1016/j.euf.2016.03.002. Epub 2016 Mar 23.
Monopolar transurethral resection of the prostate (M-TURP) is the current UK surgical standard of care for benign prostatic hyperplasia, a condition estimated to affect >2 million men in the United Kingdom. Although M-TURP efficacy in prostate resection is established, potential perioperative complications and associated costs remain a concern.
To present up-to-date and robust evidence in support of bipolar transurethral resection in saline (TURis) as an alternative surgical option to M-TURP.
A systematic review (SR) of electronic databases (up to 2015) for randomised controlled trials (RCTs) comparing TURis with M-TURP was conducted, followed by evidence synthesis in the form of a meta-analysis of hospital stay, catheterisation time and procedure duration, transurethral resection (TUR) syndrome, blood transfusion, clot retention, and urethral strictures. An economic analysis was subsequently undertaken from the UK National Health Service hospital perspective with costs and resource use data from published sources.
The SR identified 15 good-quality RCTs, of which 11 were used to inform the meta-analysis. TURis was associated with improved safety versus M-TURP, eliminating the risk of TUR syndrome and reducing the risk of blood transfusion and clot retention (relative risks: 0.34 and 0.43, respectively; p<0.05). TURis also reduced hospital stay (mean difference: 0.56 d; p<0.0001). The economic analysis indicated potential cost savings with TURis versus M-TURP of up to £204 per patient, with incremental equipment costs offset by savings from reduced hospital stay and fewer complications.
The TURis system is associated with significant improvements in perioperative safety compared with M-TURP while ensuring equivalent clinical outcomes of prostate resection. The safety benefits identified may translate into cost savings for UK health services.
Our review of bipolar transurethral resection in saline, the new prostate resection technique, indicates that it offers equal efficacy while reducing complications and length of hospital stay.
经尿道前列腺单极电切术（M-TURP）是目前英国治疗良性前列腺增生的标准手术方法，据估计，英国有超过 200 万男性受此影响。虽然 M-TURP 在前列腺切除术中的疗效已得到证实，但潜在的围手术期并发症及相关成本仍是人们关注的问题。
提供支持使用双极经尿道前列腺电切术（TURis）作为 M-TURP 替代手术的最新和可靠证据。
对电子数据库（截至 2015 年）进行了随机对照试验（RCT）的系统评价，比较 TURis 与 M-TURP 的疗效，然后以住院时间、导尿管留置时间和手术时间、经尿道前列腺电切综合征、输血、血块残留和尿道狭窄的荟萃分析形式进行证据综合。随后，从英国国家卫生服务医院的角度进行了经济分析，使用已发表的资源使用数据和成本数据。
该系统评价确定了 15 项高质量 RCT，其中 11 项用于进行荟萃分析。与 M-TURP 相比，TURis 安全性更高，消除了经尿道前列腺电切综合征的风险，并降低了输血和血块残留的风险（相对风险：0.34 和 0.43；p<0.05）。TURis 还缩短了住院时间（平均差：0.56 天；p<0.0001）。经济分析表明，与 M-TURP 相比，TURis 每例患者潜在节省费用高达 204 英镑，增量设备成本可通过减少住院时间和减少并发症而得到节省。
与 M-TURP 相比，TURis 系统在围手术期安全性方面有显著改善，同时保证了前列腺切除术的临床效果相当。所确定的安全性益处可能会为英国卫生服务带来成本节约。
我们对新的前列腺切除术技术——双极经尿道前列腺电切术在生理盐水（TURis）的研究表明，该技术在提供同等疗效的同时，减少了并发症和住院时间。
