Lan Yu, Wu Wenqi, Liu Luhao, Zhou Shiyu, Lan Chuangxin, Ketegwe Irene Raphael, Zeng Guohua
Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.
, Guangzhou, People's Republic of China.
Lasers Med Sci. 2018 Sep;33(7):1411-1421. doi: 10.1007/s10103-018-2539-0. Epub 2018 Jun 27.
Thulium laser vaporesection (ThuVARP) and bipolar transurethral resection of the prostate (B-TURP) are novel surgeries for benign prostate hyperplasia (BPH). This paper is a systematic review and analysis of literatures comparing efficacy indicators, operative parameters, as well as safety indicators between ThuVARP and B-TURP for the treatment of BPH. A systematic search of electronic databases, including PubMed, the Cochrane Library, Web of Science, Embase, and China National Knowledge Internet (CNKI), was carried out up to December 1, 2015 (updated on March 1, 2016). The captivating outcomes included basic clinical characteristics, perioperative parameters, local complications, and efficacy indicators which included International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), and postvoid residual (PVR). After assessing the quality of methodology and extracting data, a meta-analysis was carried out by using STATA 12.0 software. Five studies involving 500 patients met the standard. The outcomes of this analysis were as follows: (a) efficacy indicators: there were no significant differences in IPSS, QoL, PVR, and Qmax between the two groups (all P > 0.05); (b) perioperative indicators: ThuVARP had longer operative time [standardized mean difference (SMD) = 0.843; 95% confidence interval (CI) - 0.391, 1.296; P < 0.001] but less serum hemoglobin decreased (SMD = - 0.561; 95% CI - 0.796, - 0.327; P < 0.001), shorter hospital stay (SMD = - 1.558; 95% CI - 2.709, - 0.407; P < 0.01), and catheterization time (SMD = - 1.274; 95% CI - 2.158, - 0.390; P < 0.01). Additionally, no significant difference was found in estimated resected weight (P > 0.05); (c) safety indicators: no significant difference was found in local complication rates (all P > 0.05) between ThuVARP and B-TURP. In our analysis, there exists no statistical difference between ThuVARP and B-TURP group in efficacy. However, in spite of requiring longer surgical time, ThuVARP was better in terms of less blood loss as well as shorter hospitalization and catheterization time.
铥激光汽化切除术（ThuVARP）和双极经尿道前列腺切除术（B-TURP）是治疗良性前列腺增生（BPH）的新型手术。本文是对比较ThuVARP和B-TURP治疗BPH的疗效指标、手术参数及安全性指标的文献进行的系统综述与分析。截至2015年12月1日（2016年3月1日更新），对包括PubMed、Cochrane图书馆、科学网、Embase和中国知网（CNKI）在内的电子数据库进行了系统检索。纳入的结果包括基本临床特征、围手术期参数、局部并发症以及疗效指标，其中疗效指标包括国际前列腺症状评分（IPSS）、生活质量（QoL）、最大尿流率（Qmax）和残余尿量（PVR）。在评估方法质量并提取数据后，使用STATA 12.0软件进行了荟萃分析。五项涉及500例患者的研究符合标准。该分析结果如下：（a）疗效指标：两组间IPSS、QoL、PVR和Qmax均无显著差异（所有P>0.05）；（b）围手术期指标：ThuVARP手术时间较长[标准化均数差（SMD）=0.843；95%置信区间（CI）-0.391，1.296；P<0.001]，但血清血红蛋白下降较少（SMD=-0.561；95%CI-0.796，-0.327；P<0.001），住院时间较短（SMD=-1.558；95%CI-2.709，-0.407；P<0.01），导尿时间较短（SMD=-1.274；95%CI-2.158，-0.390；P<0.01）。此外，估计切除重量无显著差异（P>0.05）；（c）安全性指标：ThuVARP和B-TURP之间的局部并发症发生率无显著差异（所有P>0.05）。在我们的分析中，ThuVARP和B-TURP组在疗效方面不存在统计学差异。然而，尽管ThuVARP手术时间较长，但在减少失血以及缩短住院和导尿时间方面表现更好。
