Department of Urology, Medical Centre - University of Freiburg, Faculty of Medicine, Hugstetter Str. 55, 79106, Freiburg, Germany.
Clinic of Urology, Bingol State Hospital, Bingol, Turkey.
World J Urol. 2023 Nov;41(11):2949-2958. doi: 10.1007/s00345-023-04594-7. Epub 2023 Sep 10.
Laser endoscopic enucleation of the prostate (EEP) for benign prostatic obstruction has become increasingly prevalent worldwide. Considering the medical cost-savings and concomitantly fewer nosocomial infections, the feasibility of same-day postoperative discharge of patients who have undergone laser EEP in terms of its safety and effectiveness has become a subject matter of growing interest. We aimed to review those studies focussing on day-case surgery (DCS) in patients undergoing laser EEP.
A systematic search was conducted using PubMed-MEDLINE and Web of Science databases until October 2022 with the following search terms: "same day discharge AND laser enucleation of the prostate", "day-case AND laser enucleation of the prostate", "same day surgery AND laser enucleation of the prostate" and "one day surgery AND laser enucleation of the prostate" by combining PICO (population, intervention, comparison, outcome) terms. We identified 15 eligible studies.
While 14 of the studies focussed on holmium laser EEP, one focused on thulium laser vapoenucleation of the prostate. We observed an improvement in functional parameters in all studies we reviewed, and DCS success and readmission rates ranged between 35.3-100% and 0-17.8%, respectively. The complication rates varied between 0 and 36.7%, most of the complicatons were Clavien-Dindo (CD) I and II. CD ≥ III complications did not significantly differ between same day discharge (SDD) and non-SDD groups in the studies.
Laser EEP is feasible and promising DCS treatment option delivering improved functional parameters compared to baseline values, and lower perioperative complication and readmission rates in certain patients.
经尿道前列腺激光剜除术（TULERP）治疗良性前列腺梗阻在全球范围内越来越普遍。考虑到节省医疗费用和减少医院感染，行 TULERP 患者术后当日出院的可行性及其安全性和有效性已成为研究热点。我们旨在回顾那些关注激光前列腺剜除术日间手术（DCS）患者的研究。
系统检索 PubMed-MEDLINE 和 Web of Science 数据库，检索时间截至 2022 年 10 月，使用的检索词包括：“同日出院和激光前列腺剜除术”、“日间手术和激光前列腺剜除术”、“同日手术和激光前列腺剜除术”和“一日手术和激光前列腺剜除术”，并结合 PICO（人群、干预、比较、结局）术语。我们确定了 15 项符合条件的研究。
14 项研究集中于钬激光前列腺剜除术，1 项研究集中于铥激光前列腺汽化剜除术。我们观察到所有研究中功能参数均有所改善，DCS 成功率和再入院率分别为 35.3%-100%和 0%-17.8%。并发症发生率在 0%-36.7%之间，大多数并发症为 Clavien-Dindo（CD）I 级和 II 级。在研究中，CD≥III 级并发症在当日出院（SDD）和非 SDD 组之间无显著差异。
与基线值相比，激光前列腺剜除术是一种可行且有前途的 DCS 治疗选择，可改善功能参数，并降低某些患者的围手术期并发症和再入院率。
