Department of Urology, Second People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, Sichuan Province, China.
Department of Nephrology, First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, Sichuan Province, China.
Lasers Med Sci. 2024 Jul 23;39(1):190. doi: 10.1007/s10103-024-04143-7.
This meta-analysis evaluates the efficacy and safety of greenlight (PVP) and thulium laser vaporization (ThuVAP) in Benign Prostatic Hyperplasia (BPH) treatment. A systematic literature search was conducted in databases including PubMed, Cochrane Library, EMBASE, CNKI, Wangfang, and VIP in November 2023. Following the PRISMA guidelines, a systematic review and meta-analysis of the primary outcomes of interest were performed. The review was prospectively registered on PROSPERO under the registration number CRD42023491316. A total of 13 studies were included. The results of the meta-analysis showed that compared to PVP, ThuVAP had a shorter operation time (MD: 8.56, 95% CI: 4.10 ~ 13.03, p = 0.0002), and higher postoperative transfusion (OR:0.26, 95% CI: 0.10 ~ 0.64, p = 0.004). However, no significant differences were observed between the two groups in terms of length of stay (MD: -0.32, 95% CI: -0.78 ~ 0.14, p = 0.17), catherization time (MD: 0.03, 95% CI: -0.13 ~ 0.19, p = 0.73), international prostate symptom score improvement (MD: 0.23, 95% CI: -0.36 ~ 0.81, p = 0.45), quality of life improvement (MD: 0.04, 95% CI: -0.04 ~ 0.12, p = 0.29), maximum urinary flow rate improvement (MD: -0.59, 95% CI: -1.42 ~ 0.24, p = 0.16), postvoid residual urine volume improvement (MD: 1.04, 95% CI: -6.63 ~ 8.71, p = 0.79), overall postoperative complications (OR:1.15, 95% CI: 0.65 ~ 2.03, p = 0.63), postoperative bleeding (OR:1.18, 95% CI: 0.67 ~ 2.07, p = 0.56), re-peration (OR:0.55, 95% CI: 0.16 ~ 1.95, p = 0.35), urethral stricture (OR:0.90, 95% CI: 0.46 ~ 1.75, p = 0.75), and urinary incontinence (OR:1.07, 95% CI: 0.64 ~ 1.78, p = 0.80). The results of subgroup analysis showed that the results of comparing thulium vaporesection or vapoenucleation with PVP were consistent with the results of the pooled analysis. Both greenlight and thulium laser vaporization are effective and safe, with comparable surgical and functional outcomes. The choice between these methods should be based on patient-specific factors.
这项荟萃分析评估了绿光（PVP）和钬激光汽化（ThuVAP）在良性前列腺增生（BPH）治疗中的疗效和安全性。我们于 2023 年 11 月在 PubMed、Cochrane 图书馆、EMBASE、CNKI、万方和 VIP 等数据库中进行了系统的文献检索。根据 PRISMA 指南，对主要结局进行了系统评价和荟萃分析。该综述前瞻性地在 PROSPERO 上进行了注册，注册号为 CRD42023491316。共纳入 13 项研究。荟萃分析结果表明，与 PVP 相比，ThuVAP 具有更短的手术时间（MD：8.56，95%CI：4.1013.03，p=0.0002）和更高的术后输血（OR：0.26，95%CI：0.100.64，p=0.004）。然而，两组在住院时间（MD：-0.32，95%CI：-0.780.14，p=0.17）、导尿时间（MD：0.03，95%CI：-0.130.19，p=0.73）、国际前列腺症状评分改善（MD：0.23，95%CI：-0.360.81，p=0.45）、生活质量改善（MD：0.04，95%CI：-0.040.12，p=0.29）、最大尿流率改善（MD：-0.59，95%CI：-1.420.24，p=0.16）、残余尿改善（MD：1.04，95%CI：-6.638.71，p=0.79）、总术后并发症（OR：1.15，95%CI：0.652.03，p=0.63）、术后出血（OR：1.18，95%CI：0.672.07，p=0.56）、再次手术（OR：0.55，95%CI：0.161.95，p=0.35）、尿道狭窄（OR：0.90，95%CI：0.461.75，p=0.75）和尿失禁（OR：1.07，95%CI：0.64~1.78，p=0.80）方面无显著差异。亚组分析结果表明，比较钬激光汽化切割或汽化切除术与 PVP 的结果与汇总分析结果一致。绿光和钬激光汽化都是有效和安全的，具有相似的手术和功能结果。这些方法的选择应基于患者的具体情况。
