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用于良性前列腺增生的绿激光前列腺选择性汽化术(前向发射)与前列腺等离子体动力切除术的比较

GreenLight Laser photoselective vapo-enucleation of the prostate with front-firing emission versus plasmakinetic resection of the prostate for benign prostate hyperplasia.

作者信息

Cheng Xiangming, Qiu Zikai, Dong Jie, Liu Guanghua, Xie Yi, Xu Weifeng, Ji Zhigang

机构信息

Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing 210029, China.

Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.

出版信息

Transl Androl Urol. 2020 Apr;9(2):544-552. doi: 10.21037/tau.2020.02.04.

Abstract

BACKGROUND

Although the conventional, monopolar transurethral resection of the prostate (TURP) has proven to be an effective and relatively safe treatment for patients with benign prostatic hyperplasia (BPH), many new endoscopic technologies have been introduced to treat BPH. With the development of laser, there are several alternative transurethral procedures embracing laser therapies. Herein, this study sought to explore the efficacy, safety and follow-up of GreenLight laser photoselective vapo-enucleation of the prostate (PVEP) with front-firing emission compared with plasmakinetic resection of the prostate (PKRP) used to surgically manage BPH.

METHODS

Data from patients who underwent either GreenLight laser PVEP or PKRP were retrospectively collected from March 2013 to May 2018. Perioperative data from both groups were compared.

RESULTS

Totally, 43 and 45 patients were included in the PVEP and PKRP groups, respectively. No significant difference was observed in excision efficiency ratio (resected prostate weight/operation time) between the two groups (P=0.372). The efficiency ratio of the first 20 PVEP procedures (0.36±0.09 g/min) was significantly lower than that of the second 23 PVEP procedures (0.45±0.18 g/min) (P=0.042). The PVEP group experienced a shorter duration of catheterization, postoperative hospital stay and irrigation time than the PKRP group (P<0.001, P=0.001 and P<0.001, respectively). There was no statistically significant difference between the two groups (P=0.937) in terms of overall postoperative complications. Three months after surgery, the international prostate symptoms (IPSS) score, quality of life (QOL) score, postvoid residual (PVR) volume and maximum urinary flow rate (Q) were decreased in both groups (P<0.001 for all) and were comparable between both groups (P=0.635, 0.662, 0.671 and 0.924, respectively).

CONCLUSIONS

GreenLight laser PVEP with front-firing emission was safe and effective modality in treating patients with BPH with short-term follow-up. PVEP was associated with shorter catheterization and postoperative hospital stay time compared with PKRP.

摘要

背景

尽管传统的单极经尿道前列腺切除术(TURP)已被证明是治疗良性前列腺增生(BPH)患者的一种有效且相对安全的方法,但许多新的内镜技术已被引入用于治疗BPH。随着激光技术的发展,出现了几种包括激光疗法在内的替代经尿道手术。在此,本研究旨在探讨与用于手术治疗BPH的等离子双极前列腺切除术(PKRP)相比,采用前向发射的GreenLight激光前列腺选择性汽化剜除术(PVEP)的疗效、安全性及随访情况。

方法

回顾性收集2013年3月至2018年5月期间接受GreenLight激光PVEP或PKRP治疗的患者数据。比较两组的围手术期数据。

结果

PVEP组和PKRP组分别纳入43例和45例患者。两组间切除效率比(切除前列腺重量/手术时间)无显著差异(P = 0.372)。前20例PVEP手术的效率比(0.36±0.09 g/min)显著低于后23例PVEP手术的效率比(0.45±0.18 g/min)(P = 0.042)。PVEP组的导尿时间、术后住院时间和冲洗时间均短于PKRP组(分别为P<0.001、P = 0.001和P<0.001)。两组术后总体并发症无统计学显著差异(P = 0.937)。术后三个月时,两组的国际前列腺症状(IPSS)评分、生活质量(QOL)评分、残余尿量(PVR)和最大尿流率(Q)均降低(均为P<0.001),且两组间具有可比性(分别为P = 0.635、0.662、0.671和0.924)。

结论

采用前向发射的GreenLight激光PVEP是一种治疗BPH患者安全有效的方式,短期随访效果良好。与PKRP相比,PVEP的导尿时间和术后住院时间更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e06d/7215003/e6970fd67455/tau-09-02-544-f1.jpg

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