Gu Zhi-Bo, Qiu Lei, Zhu Hua, Lu Ming, Chen Jian-Gang
Department of Urology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu Province, 226200, People's Republic of China.
Ther Clin Risk Manag. 2024 Sep 11;20:633-639. doi: 10.2147/TCRM.S472153. eCollection 2024.
To compare low- vs high-power HoLEP effects on coagulation in patients on antiplatelet (AP) therapy via thromboelastography (TEG).
210 patients was retrospectively analyzed and stratificated into three discrete groups, specifically: Group A (AP therapy, high-power HoLEP, n = 72); Group B (AP therapy, low-power HoLEP, n=73); Group C (no AP therapy, low-power HoLEP, n = 65). Baseline characteristics and coagulation profiles via TEG were compared. Univariate and multivariate analyses were conducted to identify independent risk factors associated with hematuria. Furthermore, parameters such as IPSS, Qmax, post-void residual volume V and PSA levels were recorded during 1year follow-up.
No differences in terms of baseline characteristics across all groups. Significant differences were observed in the duration of enucleation, morcellation, bladder irrigation, post-operative catheterization, length of hospital stay and the extent of hemoglobin reduction (F = 54.06, 8.54, 6.68, 9.24, 17.06, 5.97, p < 0.05). No differences were noted in postoperative hematuria, urine retention, transfusion rates, and SUI (x = 1.082 ; x = 0.197,; x = 3.981;x = 0.816, p > 0.05). Univariate and multivariate analyses revealed that prostate volume emerged as an independent risk factor for hematuria (OR 1.080, 95% CI: 1.007-1.158, p = 0.031). Clinical outcomes including Qmax, IPSS, V, and PSA demonstrated significant enhancement during 1 year follow-up.
Compared to HP-HoLEP, LP-HoLEP effectively reduces surgical and subsequent processing times, decreases hospital stay duration, and diminishes hemoglobin decline, offering a viable option without discontinuing AP therapy.
通过血栓弹力图（TEG）比较低功率与高功率钬激光前列腺剜除术（HoLEP）对接受抗血小板（AP）治疗患者凝血功能的影响。
对210例患者进行回顾性分析，并分为三个不同组，具体为：A组（AP治疗，高功率HoLEP，n = 72）；B组（AP治疗，低功率HoLEP，n = 73）；C组（未接受AP治疗，低功率HoLEP，n = 65）。比较基线特征及通过TEG得出的凝血指标。进行单因素和多因素分析以确定与血尿相关的独立危险因素。此外，在1年随访期间记录国际前列腺症状评分（IPSS）、最大尿流率（Qmax）、残余尿量（V）和前列腺特异性抗原（PSA）水平等参数。
所有组的基线特征无差异。在剜除、粉碎、膀胱冲洗、术后导尿时间、住院时间和血红蛋白降低程度方面观察到显著差异（F = 54.06、8.54、6.68、9.24、17.06、5.97，p < 0.05）。术后血尿、尿潴留、输血率和压力性尿失禁方面无差异（χ² = 1.082；χ² = 0.197；χ² = 3.981；χ² = 0.816，p > 0.05）。单因素和多因素分析显示前列腺体积是血尿的独立危险因素（OR 1.080，95%置信区间：1.007 - 1.158，p = 0.031）。包括Qmax、IPSS、V和PSA在内的临床结局在1年随访期间有显著改善。
与高功率HoLEP相比，低功率HoLEP有效缩短手术及后续处理时间，减少住院时间，减轻血红蛋白下降，为不停用AP治疗提供了可行选择。
