Tan Xinji, Zhang Xiaobo, Li Dongjie, Chen Xiong, Dai Yuanqing, Gu Jie, Chen Mingquan, Hu Sheng, Bai Yao, Ning Yu
Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China.
The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Lasers Med Sci. 2018 May;33(4):891-897. doi: 10.1007/s10103-018-2499-4. Epub 2018 Apr 10.
This study compared the safety and effectiveness of the diode laser and thulium laser during prostate transurethral vaporesection for treating benign prostate hyperplasia (BPH). We retrospectively analyzed 205 patients with BPH who underwent a diode laser or thulium laser technique for prostate transurethral vaporesection from June 2016 to June 2017 and who were followed up for 3 months. Baseline characteristics of the patients, perioperative data, postoperative outcomes, and complications were compared. We also assessed the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Q), average flow rate (AFR), and postvoid residual volume (PVR) at 1 and 3 months postoperatively to evaluate the functional improvement of each group. There were no significant differences between the diode laser and thulium laser groups related to age, prostate volume, operative time, postoperative hospital stays, hospitalization costs, or perioperative data. The catheterization time was 3.5 ± 0.8 days for the diode laser group and 4.7 ± 1.8 days for the thulium laser group (p < 0.05). Each group had dramatic improvements in IPSS, QoL, Q, AFR, and PVR compared with the preoperative values (p < 0.05), although there were no significant differences between the two groups. Use of both diode laser and thulium laser contributes to safe, effective transurethral vaporesection in patients with symptomatic BPH. Diode laser, however, is better than thulium laser for prostate transurethral vaporesection because of its shorter catheterization time. The choice of surgical approach is more important than the choice of laser types during clinical decision making for transurethral laser prostatectomy.
本研究比较了二极管激光和铥激光在经尿道前列腺汽化切除术治疗良性前列腺增生（BPH）中的安全性和有效性。我们回顾性分析了205例2016年6月至2017年6月期间接受二极管激光或铥激光经尿道前列腺汽化切除术并随访3个月的BPH患者。比较了患者的基线特征、围手术期数据、术后结果及并发症。我们还评估了术后1个月和3个月时的国际前列腺症状评分（IPSS）、生活质量（QoL）、最大尿流率（Q）、平均尿流率（AFR）和残余尿量（PVR），以评估每组的功能改善情况。二极管激光组和铥激光组在年龄、前列腺体积、手术时间、术后住院时间、住院费用或围手术期数据方面无显著差异。二极管激光组的导尿时间为3.5±0.8天，铥激光组为4.7±1.8天（p<0.05）。与术前值相比，每组的IPSS、QoL、Q、AFR和PVR均有显著改善（p<0.05），尽管两组间无显著差异。二极管激光和铥激光均有助于对有症状的BPH患者进行安全、有效的经尿道汽化切除术。然而，二极管激光在经尿道前列腺汽化切除术中优于铥激光，因为其导尿时间更短。在经尿道激光前列腺切除术的临床决策中，手术方式的选择比激光类型的选择更为重要。
