钬激光前列腺剜除术联合虚拟篮（Virtual Basket）模式：更快更好地控制出血。
Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding.
机构信息
Department of Urology, ASST Valle Olona, Via Arnaldo da Brescia, 21052, Busto Arsizio, VA, Italy.
ESUT, European Section for UroTechnology, Arnhem, Italy.
出版信息
BMC Urol. 2021 Feb 23;21(1):28. doi: 10.1186/s12894-021-00797-5.
BACKGROUND
To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH).
METHODS
This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS).
RESULTS
No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated.
CONCLUSIONS
HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up.
TRIAL REGISTRATION
Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.
背景
比较传统钬激光前列腺剜除术（HoLEP）和使用虚拟篮工具的钬激光前列腺剜除术（VB-HoLEP）治疗前列腺增生（BPH）的临床术中及早期术后结果。
方法
这项前瞻性随机研究纳入了连续的 BPH 患者，他们被分为接受 HoLEP（n=100）或 VB-HoLEP（n=100）的治疗。所有患者在术前和术后均进行评估，特别关注导尿时间、手术时间、出血量、灌洗量和住院时间。我们还在术后 3 个月和 6 个月评估了患者，并评估了最大尿流率（Qmax）、残余尿量（PVR）、国际前列腺症状评分（IPSS）和生活质量评分（QOLS）。
结果
两组患者术前各项参数无显著差异。与 HoLEP 相比，VB-HoLEP 导致的血红蛋白下降更少（2.54 vs. 1.12 g/dl，P=0.03），手术时间更短（57.33±29.71 vs. 42.99±18.51 min，P=0.04）。HoLEP 和 VB-HoLEP 导尿时间相似（2.2 vs. 1.9 天，P=0.45），灌洗量相似（33.3 vs. 31.7 l，P=0.69），住院时间相似（2.8 vs. 2.7 天，P=0.21）。在 6 个月的随访期间，两组的 IPSS、Qmax、PVR 和 QOLS 均无显著差异。
结论
HoLEP 和 VB-HoLEP 都是缓解下尿路症状的有效且安全的手术方法。VB-HoLEP 在出血量和手术时间方面明显优于 HoLEP。然而，在导尿时间、住院时间和灌洗量方面，两种方法无显著差异。在 6 个月的随访期间，QOLS、IPSS、Qmax 和 PVR 也无显著差异。
试验注册
当前对照试验 ISRCTN72879639；注册日期：2015 年 6 月 25 日。回顾性注册。
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