Department of Urology and Urologic Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
Department of Urology, Heilig-Geist Hospital, Bensheim, Germany.
Urol Int. 2023;107(7):678-683. doi: 10.1159/000530627. Epub 2023 Jun 12.
The aim of this study was to investigate and compare clinical safety and efficiency of Thulium laser enucleation of the prostate (ThuLEP) and robot-assisted simple prostatectomy (RASP) for the treatment of large gland benign prostatic hyperplasia in a tertiary care center.
Perioperative data of 39 patients who underwent RASP in our institution from 2015 to 2021 was collected. Propensity score matching using prostate volume, patient age, and body mass index (BMI) was performed from a database of 1,100 Patients treated by ThuLEP from 2009 to 2021. A total of 76 patients were matched. Preoperative parameters such as BMI, age, and prostate volume, as well as intra- and postoperative parameters such as operation time, resection weight, transfusion rate, postoperative catheterization time, length of hospital stay (LoS), hemoglobin drop, postoperative urinary retention (PUR), Clavien-Dindo Classification (CDC), and the Combined Complication Index (CCI), were evaluated.
There was no difference in mean hemoglobin drop (2.2 vs. 1.9 g/dL, p = 0.34), yet endoscopic surgery showed superiority in mean operation time (109 vs. 154 min, p < 0.001), mean postoperative catheterization time (3.3 vs. 7.2 days, p < 0.001), and mean LOS (5.4 vs. 8.4 days, p < 0.001). Complication rates evaluated by CDC (p = 0.11) and CCI (p = 0.89) were similar in both groups. Within the documented complications, transfusion rate (0 vs. 3, p = 0.08) and the occurrence of PUR (1 vs. 2, p = 0.5) showed no significant difference.
ThuLEP and RASP show similar perioperative efficacy and a low rate of complications. ThuLEP had shorter operation times, shorter catheterization time, and a shorter LoS.
本研究旨在探讨和比较钬激光前列腺剜除术（ThuLEP）和机器人辅助单纯前列腺切除术（RASP）治疗大型前列腺良性前列腺增生的临床安全性和疗效。
收集 2015 年至 2021 年在我院行 RASP 的 39 例患者的围手术期资料。从 2009 年至 2021 年接受 ThuLEP 治疗的 1100 例患者的数据库中，根据前列腺体积、患者年龄和体重指数（BMI）进行倾向评分匹配。共匹配 76 例患者。评估了术前参数（如 BMI、年龄和前列腺体积）以及术中术后参数（如手术时间、切除重量、输血率、术后导尿管留置时间、住院时间（LoS）、血红蛋白下降、术后尿潴留（PUR）、Clavien-Dindo 分类（CDC）和联合并发症指数（CCI）。
两组平均血红蛋白下降量无差异（2.2 与 1.9 g/dL，p = 0.34），但内镜手术在平均手术时间（109 与 154 min，p < 0.001）、平均术后导尿管留置时间（3.3 与 7.2 天，p < 0.001）和平均 LOS（5.4 与 8.4 天，p < 0.001）方面具有优势。两组的 CDC（p = 0.11）和 CCI（p = 0.89）评估的并发症发生率相似。在记录的并发症中，输血率（0 与 3，p = 0.08）和 PUR 发生率（1 与 2，p = 0.5）无显著差异。
ThuLEP 和 RASP 显示出相似的围手术期疗效和较低的并发症发生率。ThuLEP 具有较短的手术时间、较短的导尿管留置时间和较短的 LoS。
