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1470nm 二极管激光前列腺剜除术与等离子前列腺切除术治疗良性前列腺增生的随机对照研究。

1470 nm Diode Laser Enucleation vs Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia: A Randomized Study.

机构信息

Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, P.R. China.

出版信息

J Endourol. 2019 Mar;33(3):211-217. doi: 10.1089/end.2018.0499. Epub 2019 Jan 9.

Abstract

OBJECTIVE

The purpose of the current work was to comparatively assess 1470 nm diode laser enucleation of the prostate (DiLEP) and plasmakinetic resection of the prostate (PKRP) for treating benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS

From January 2016 to March 2017, 157 individuals with bladder outflow obstruction caused by BPH were randomized to DiLEP and PKRP groups, for prospective analysis. Of these, 152 cases were evaluated before operation and at 3, 6, and 12 months postsurgery. Patient baseline properties, presurgery data, and postsurgical outcomes were comparatively assessed, as well as complications.

RESULTS

There were no significant preoperative differences between surgical groups. DiLEP-treated cases showed remarkable reduced operative time, postsurgical bladder irrigation time, catheterization duration, and hospital stay compared with the PKRP group (P < 0.001). Hemoglobin amount decrease was markedly less pronounced after DiLEP (P = 0.004). However, no patients needed blood transfusion in either group. The decrease in sodium level showed no marked differences between the DiLEP and PKRP groups (P = 0.380). In addition, complications were comparable and no significant differences in both groups. At 3, 6, and 12 months, International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), and postvoid residual (PVR) were similar in both groups (P > 0.05).

CONCLUSIONS

DiLEP and PKRP are similar in efficacy and safety for relieving obstruction and low urinary tract symptoms. Compared with PKRP, DiLEP has decreased risk of hemorrhage, operative time, bladder irrigation time, catheterization duration, and hospital stay. However, IPSS, QoL, Qmax, and PVR were similar for both procedures within 12 postoperative months.

摘要

目的

本研究旨在对比评估 1470nm 二极管激光前列腺切除术(DiLEP)与经尿道等离子前列腺切除术(PKRP)治疗良性前列腺增生(BPH)的效果。

患者与方法

2016 年 1 月至 2017 年 3 月,157 例因 BPH 导致膀胱出口梗阻的患者被随机分为 DiLEP 组和 PKRP 组,进行前瞻性分析。其中,152 例患者在术前、术后 3、6、12 个月进行了评估。对比评估了患者的基线特征、术前数据和术后结果,以及并发症情况。

结果

两组患者术前无显著差异。与 PKRP 组相比,DiLEP 组手术时间、术后膀胱冲洗时间、导尿管留置时间和住院时间明显缩短(P<0.001)。血红蛋白下降量也明显小于 PKRP 组(P=0.004)。但两组均无患者需要输血。两组间血清钠下降量无显著差异(P=0.380)。此外,两组并发症发生率相当,无显著差异。在术后 3、6、12 个月,两组国际前列腺症状评分(IPSS)、生活质量评分(QoL)、最大尿流率(Qmax)和剩余尿量(PVR)均相似(P>0.05)。

结论

DiLEP 和 PKRP 在缓解梗阻和下尿路症状方面的疗效和安全性相当。与 PKRP 相比,DiLEP 具有较低的出血风险、手术时间、膀胱冲洗时间、导尿管留置时间和住院时间。然而,在术后 12 个月内,两组患者的 IPSS、QoL、Qmax 和 PVR 相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/189a/6441285/18a51992c23e/fig-1.jpg

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