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80瓦绿激光汽化术与经尿道前列腺切除术治疗良性前列腺梗阻:单中心前瞻性随机试验的5年结果

80-W GreenLight Laser Vaporization Versus Transurethral Resection of the Prostate for Treatment of Benign Prostatic Obstruction: 5-Year Outcomes of a Single-center Prospective Randomized Trial.

作者信息

Mordasini Livio, Di Bona Carlo, Klein Jacques, Mattei Agostino, Wirth Gregory J, Iselin Christophe E

机构信息

Department of Surgery, Division of Urology, Geneva University Hospital, Switzerland; Department of Urology, Lucerne Cantonal Hospital, Spitalstrasse, 6000, Lucerne, Switzerland.

Department of Obstetrics and Gynecology Sciences and Urologic Sciences, "Sapienza" University, Rome, Italy.

出版信息

Urology. 2018 Jun;116:144-149. doi: 10.1016/j.urology.2018.01.037. Epub 2018 Feb 12.

Abstract

OBJECTIVE

To assess long term functional and safety follow-up data after 80-W GreenLight photoselective vaporization (GL PV) of the prostate and transurethral resection of the prostate (TURP).

MATERIALS AND METHODS

Prospective randomized trial at a single tertiary referral center (Geneva, Switzerland). Patients were recruited in the outpatient clinic if they met the criteria for surgical treatment of benign prostatic obstruction. At baseline, 238 patients were treated either with the 80-W GL PV or monopolar TURP. After 5 years, data were available from 105 patients: 44 GL PV patients and 61 TURP patients. The primary outcome measure was the International Prostate Symptom Score (IPSS). Secondary outcome measures included maximum urinary flow rate (Qmax), postvoidal residual (PVR) and reoperation rate. Statistical analyses were performed using Stata 14 (StataCorp).

RESULTS

After 5 years of follow-up, mean improvements in International Prostate Symptom Score, postvoidal residual and maximum urinary flow rate were similar in both groups. The re-treatment rate was 14.3% in the GL PV group vs 11.9% in the TURP group (P = .9).

CONCLUSION

Noninferiority of the GL PV to TURP was confirmed in all functional and safety outcomes at 5-year follow-up. GL-PV could be a safe surgical alternative for patients suffering from benign prostatic obstruction.

摘要

目的

评估80瓦绿激光前列腺选择性汽化术(GL PV)和经尿道前列腺切除术(TURP)后的长期功能及安全性随访数据。

材料与方法

在一家三级转诊中心(瑞士日内瓦)进行前瞻性随机试验。符合良性前列腺梗阻手术治疗标准的患者在门诊招募。基线时,238例患者接受了80瓦GL PV或单极TURP治疗。5年后,获得了105例患者的数据:44例GL PV患者和61例TURP患者。主要结局指标是国际前列腺症状评分(IPSS)。次要结局指标包括最大尿流率(Qmax)、残余尿量(PVR)和再次手术率。使用Stata 14(StataCorp)进行统计分析。

结果

随访5年后,两组患者的国际前列腺症状评分、残余尿量和最大尿流率的平均改善情况相似。GL PV组的再治疗率为14.3%,TURP组为11.9%(P = 0.9)。

结论

在5年随访中,GL PV在所有功能和安全性结局方面均不劣于TURP。GL-PV可能是良性前列腺梗阻患者的一种安全手术选择。

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