Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Urology, Chengdu Xinhua Hospital Affiliated to North Sichuan Medical College, Chengdu, China.
J Robot Surg. 2023 Dec;17(6):2633-2646. doi: 10.1007/s11701-023-01715-7. Epub 2023 Sep 20.
To compare perioperative outcomes between Holmium laser enucleation of the prostate (HoLEP) and robotic-assisted simple pasta-ectomy (RASP)for large-volume benign prostatic hyperplasia(> 80 ml). In August 2023, we undertook a comprehensive search of major global databases including PubMed, Embase, and Google Scholar, focusing solely on articles written in English. Studies that were merely reviews or protocols without any specific published data were omitted. Furthermore, articles that comprised conference abstracts or content not pertinent to our subject of study were also disregarded. To calculate the inverse variances and 95% confidence intervals (CIs) for categorical variables' mean differences, we employed the Cochran-Mantel-Haenszel approach along with random-effects models. The findings were denoted in the form of odds ratios (ORs) and 95% CIs. A p-value less than 0.05 was deemed to indicate statistical significance. Our finalized meta-analysis incorporated six articles, including one randomized controlled trial (RCT) and five cohort studies. These studies accounted for a total of 1218 patients, 944 of whom underwent Holmium Laser Enucleation of the Prostate (HoLEP) and 274 who underwent Robotic-Assisted Simple Prostatectomy (RASP). The pooled analysis from these six papers demonstrated that compared to RASP, HoLEP had a shorter hospital stay, shorter catheterization duration, and a lower blood transfusion rate. Moreover, HoLEP patients exhibited a smaller reduction in postoperative hemoglobin levels. Statistically, there were no significant differences between the two procedures regarding operative time, postoperative PSA, the weight of prostate specimens, IPSS, Qmax, PVR, QoL, and postoperative complications. (HoLEP) and (RASP) are both effective and safe procedures for treating large-volume benign prostatic hyperplasia. HoLEP, with its benefits of shorter catheterization and hospitalization duration, lesser decline in postoperative hemoglobin, and reduced blood transfusion needs, stands as a preferred choice for treating extensive prostate enlargement. However, further validation through more high-quality clinical randomized trials is required.
比较经尿道钬激光前列腺剜除术（HoLEP）和机器人辅助简单前列腺切除术（RASP）治疗大体积良性前列腺增生（>80ml）的围手术期结果。2023 年 8 月，我们对包括 PubMed、Embase 和 Google Scholar 在内的主要全球数据库进行了全面检索，仅关注以英文撰写的文章。我们排除了仅为综述或方案且没有任何具体发表数据的研究，以及仅包含会议摘要或与我们研究主题无关内容的文章。为了计算分类变量均值差异的逆方差和 95%置信区间（CI），我们采用了 Cochran-Mantel-Haenszel 方法和随机效应模型。结果表示为比值比（OR）和 95%CI。p 值小于 0.05 表示具有统计学意义。我们的最终荟萃分析纳入了 6 篇文章，其中包括 1 项随机对照试验（RCT）和 5 项队列研究。这些研究共纳入 1218 例患者，其中 944 例行钬激光前列腺剜除术（HoLEP），274 例行机器人辅助简单前列腺切除术（RASP）。这 6 篇论文的汇总分析表明，与 RASP 相比，HoLEP 具有更短的住院时间、更短的导管插入时间和更低的输血率。此外，HoLEP 患者术后血红蛋白水平下降幅度较小。统计学上，两种手术在手术时间、术后 PSA、前列腺标本重量、IPSS、Qmax、PVR、QoL 和术后并发症方面无显著差异。（HoLEP）和（RASP）均是治疗大体积良性前列腺增生的有效且安全的方法。HoLEP 具有缩短导管插入和住院时间、减少术后血红蛋白下降、减少输血需求的优势，是治疗广泛前列腺增大的首选方法。但是，需要更多高质量的临床随机试验来进一步验证。
