Long-term results of thulium laser resection of the prostate: a prospective study at multiple centers
Long-term results of thulium laser resection of the prostate: a prospective study at multiple centers
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DOI：
10.1007/s00345-014-1456-5
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发表时间：
2015-04-01
影响因子：
3.4
通讯作者：
Guo, Fengfu
中科院分区：
文献类型：
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作者：
Sun, Feng;Han, Bangmin;Guo, Fengfu
为了通过一项前瞻性多中心研究评估经尿道前列腺激光切除术（TmLRP）后的长期耐久性和并发症发生率，我们前瞻性研究了2004年11月至2011年12月在四个医疗中心接受经尿道前列腺激光切除术治疗的2，216例症状性良性前列腺增生（BPH）患者。对患者进行国际前列腺症状评分（IPSS）、生活质量（QoL）、最大尿流率（Q（max））和排尿后残余尿（PVR）评估。围手术期并发症根据改良的Clavien分类系统进行分类。在接受TmLRP治疗的2，216例患者中，分别有1，353例（61.1%）、1，129例（50.9%）、847例（38.2%）和541例（24.4%）患者在5年、6年、7年和8年时接受了随访。术后IPSS、QoL、Q（max）和PVR从术后3个月开始显著改善，并在整个随访期间保持显著改善（p < 0.01）。2，216例患者中有526例（23.7%）发生轻微并发症（Clavien 1：21.5%; Clavien 2：2.3%）。2，216例患者中有48例（2.2%）发生了需要再次介入的严重并发症（Clavien 3：2.2%）。未发生Clavien 4或Clavien 5并发症。尿道狭窄和膀胱颈挛缩发生率分别为2.6%（58）和1.6%（35）。持续性压力性尿失禁发生率为0.1%（2例）。1.2%（27）的患者因BPH复发而需要再次手术。Thuronium激光前列腺切除术是治疗症状性BPH的一种安全有效的方法，具有良好的持久性。
To evaluate the long-term durability and complication rates after thulium laser resection of prostate (TmLRP) through a prospective multiple-center study.From November 2004 to December 2011, we prospectively studied 2,216 patients with symptomatic benign prostatic hyperplasia (BPH) treated with thulium laser resection of the prostate at four medical centers. Patients were assessed on International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Q(max)), and postvoid residual urine (PVR). Perioperative complications were classified according to the modified Clavien classification system.Of 2,216 patients treated with TmLRP, 1,353 (61.1 %), 1,129 (50.9 %), 847 (38.2 %), and 541 (24.4 %) patients were followed at 5, 6, 7, and 8 years, respectively. Postoperatively, IPSS, QoL, Q(max,) and PVR showed a significant improvement from 3 month after surgery and remained significantly improved during the entire follow-up period (p < 0.01). Minor complications occurred in 526 (23.7 %) of the 2,216 patients (Clavien 1: 21.5 %; Clavien 2: 2.3 %). Major complications requiring re-interventions occurred in 48 (2.2 %) of the 2,216 patients (Clavien 3: 2.2 %). No Clavien 4 or Clavien 5 complication had occurred. Urethral stricture and bladder neck contracture occurred in 2.6 % (58) and 1.6 % (35) patients, respectively. Persistent stress incontinence was found in 0.1 % (2) of the patients. Re-operation as a result of BPH recurrence was required in 1.2 % (27) patients.Thulium laser resection of the prostate is a safe and effective procedure with excellent durability in the treatment of symptomatic BPH.