Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates > 80 ml: 18-month follow-up results
Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates > 80 ml: 18-month follow-up results
复制标题
钬激光前列腺剜除术与铥激光前列腺剜除术治疗> 80 ml的大体积前列腺：18个月的随访结果
DOI：
10.1007/s00345-019-02945-x
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发表时间：
2020-06-01
影响因子：
3.4
通讯作者：
Wang, Long
中科院分区：
文献类型：
--
作者：
Zhang, Junjie;Ou, Zhenyu;Wang, Long
目的：比较钬激光前列腺剜除术 (HoLEP) 和铥激光前列腺剜除术 (ThuLEP) 治疗大体积良性前列腺增生 (BPH)（> 80 ml）的围手术期和功能结果。方法：总共 116 名连续的 BPH 患者被随机分配接受 HoLEP (n = 58) 或 ThuLEP (n =) 手术治疗58），遵循经典的三叶剜除技术。术后1、3、6、12、18个月进行随访。结果：18个月时，两组下尿路症状指数较基线值均显着改善。与 HoLEP 相比，ThuLEP 的手术时间（78.4 ± 8.0 对比 71.4 ± 6.4 分钟）和摘除时间（61.2 ± 5.4 对比 56.4 ± 8.4 分钟）显着更短（均 p < 0.001）。两组在粉碎时间、切除重量、血红蛋白下降、导管时间和住院时间方面没有显着差异（p > 0.05）。 HoLEP 和 ThuLEP 组具有相同的国际前列腺症状评分（3 [3-3] vs. 3 [3-3]，p = 0.776）、生活质量（1 [1-2] vs. 2 [1-2]，p = 0.809）、Qmax（25.3 ± 4.8 ml/s vs. 24.7 ± 4.4 ml/s，p =术后 18 个月时，排尿后残余尿 (PVR)（6.1 [2.6-20.8] vs. 7.7 [3.1-22.8] ml，p = 0.449）和 PSA（0.84 ± 0.32 vs. 0.90 ± 0.34 ml，p = 0.309）。结论：HoLEP 和 ThuLEP 均缓解较低以类似的方式治疗泌尿道症状，具有较高的有效性和安全性。尽管临床上差异可以忽略不计，但 ThuLEP 在手术时间和摘除时间方面在统计学上优于 HoLEP。
Purpose:To compare the perioperative and functional outcomes of holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP) for the treatment of large-volume benign prostatic hyperplasia (BPH) (> 80 ml).Methods:A total of 116 consecutive patients with BPH were randomized to be treated surgically with either HoLEP (n = 58) or ThuLEP (n = 58), following the classical three-lobe enucleation technique. Follow-up was assessed at 1, 3, 6, 12 and 18 months after surgery.Results:At 18 months, the lower urinary tract symptom index was improved significantly in both groups compared with the baseline values. The operative time (78.4 ± 8.0 vs. 71.4 ± 6.4 min) and enucleation time (61.2 ± 5.4 vs. 56.4 ± 8.4 min) were significantly shorter for ThuLEP compared to HoLEP (both p < 0.001). There were no significant differences between the two groups regarding morcellation time, resected weight, hemoglobin decrease, catheter time and hospital stay (p > 0.05). The HoLEP and ThuLEP groups had equivalent International Prostate Symptom Scores (3 [3-3] vs. 3 [3-3], p = 0.776), quality of life (1 [1-2] vs. 2 [1-2], p = 0.809), Qmax (25.3 ± 4.8 ml/s vs. 24.7 ± 4.4 ml/s, p = 0.470), postvoid residual urine (PVR) (6.1 [2.6-20.8] vs. 7.7 [3.1-22.8] ml, p = 0.449) and PSA (0.84 ± 0.32 vs. 0.90 ± 0.34 ml, p = 0.309) at 18 months postoperatively.Conclusion:Both HoLEP and ThuLEP relieve lower urinary tract symptoms in a comparable way with high efficacy and safety. ThuLEP was statistically superior to HoLEP in operation time and enucleation time, although the differences were clinically negligible.