Tokatli Zafer, Ferhat Mehmet, Ibis Muhammed Arif, Turkmen Sariyildiz Gulcin, Elhan Atilla, Sarica Kemal
Department of Urology, Medicana International Ankara Hospital, Ankara, Turkey.
Department of Urology, Medicana Bahçelievler Hospital, Istanbul, Turkey.
Int J Clin Pract. 2021 Oct;75(10):e14531. doi: 10.1111/ijcp.14531. Epub 2021 Jun 26.
The objectives of this prospective study were to evaluate the efficiency, safety and applicability of medium-power (MP) holmium laser devices in the endoscopic enucleation of the enlarged prostate (HoLEP) compared with high-power (HP) laser devices.
From October 2019 to July 2020, a total of 120 consecutive patients planned for HoLEP were divided randomly into two groups formed in terms of the power of the device used. While patients in group 1 were treated with a MP device (50 W) at 39.6 W (2.2 J/18 Hz), patients in group 2 were treated with HP (100 W) device at 42 W (1.2 J/35 Hz). Preoperative patient characteristics, perioperative measures and 3-month functional outcomes were evaluated in both groups with an emphasis on enucleation efficiency (EE) and haemoglobin decrease in a comparative manner.
All patients underwent successful HoLEP surgery with no severe perioperative and postoperative complications. No statistically significant differences were observed in terms of preoperative patient characteristics and perioperative measures in the two groups. The median EE values in groups 1 and 2 were 1.15 (interquartile range [IQR]: 0.33-2.2) and 1.11 (IQR: 0.4-2.8), respectively (P = .775). Haemoglobin decrease values in groups 1 and 2 were 1.3 (IQR: 0.1-4) and 1.4 (IQR: 0.4-3.1), respectively (P = .736). There was no difference in terms of either catheterisation time or hospital stay in the groups. In the model created to predict haemoglobin decrease, only biopsy was detected to be the independent predictive factor among the data from laser device, biopsy and antithrombotic use. Functional outcomes markedly improved in all patients without any statistically significant difference between the groups in the 3-month follow-up.
Our comparative study indicated that HoLEP can be performed safely and effectively with MP laser devices without any technical difficulties and with comparable results achieved in HP laser devices.
这项前瞻性研究的目的是评估与高功率（HP）激光设备相比，中功率（MP）钬激光设备在内镜下前列腺剜除术（HoLEP）中的效率、安全性和适用性。
从2019年10月至2020年7月，共有120例计划接受HoLEP的连续患者根据所使用设备的功率随机分为两组。第1组患者使用MP设备（50W），以39.6W（2.2J/18Hz）进行治疗，第2组患者使用HP（100W）设备，以42W（1.2J/35Hz）进行治疗。对两组患者的术前特征、围手术期指标和3个月的功能结局进行评估，重点是以比较的方式评估剜除效率（EE）和血红蛋白下降情况。
所有患者均成功接受HoLEP手术，无严重围手术期和术后并发症。两组患者的术前特征和围手术期指标无统计学显著差异。第1组和第2组的EE中位数分别为1.15（四分位间距[IQR]：0.33 - 2.2）和1.11（IQR：0.4 - 2.8）（P = 0.775）。第1组和第2组的血红蛋白下降值分别为1.3（IQR：0.1 - 4）和1.4（IQR：0.4 - 3.1）（P = 0.736）。两组患者的导尿时间和住院时间均无差异。在用于预测血红蛋白下降的模型中，在激光设备、活检和抗血栓药物使用的数据中，仅活检被检测为独立预测因素。所有患者的功能结局均显著改善，在3个月的随访中两组之间无任何统计学显著差异。
我们的比较研究表明，使用MP激光设备可以安全有效地进行HoLEP，没有任何技术困难，且结果与HP激光设备相当。
