Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a Randomized clinical trial
Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a Randomized clinical trial
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DOI：
10.1016/j.eururo.2007.04.053
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发表时间：
2007-11-01
期刊：
影响因子：
23.4
通讯作者：
Kuntz, Rainer M.
中科院分区：
文献类型：
--
作者：
Ahyai, Sascha A.;Lehrich, Karin;Kuntz, Rainer M.
目的：报告一项比较钬激光前列腺剜除术 (HoLEP) 与经尿道前列腺切除术 (TURP) 的随机临床试验的 3 年随访结果。方法：将 200 名尿动力学梗阻且前列腺体积小于 100 cc 的患者前瞻性随机分配至 HoLEP 或 TURP。所有患者均在术前进行评估，并在术后 1、6、12、18、24 和 36 个月进行随访。每次随访时均获得美国泌尿外科协会症状评分 (AUA SS)、最大尿流率 (Q(max)) 和排尿后残留 (PVR) [尿液] 量。比较围手术期数据和术后结果。记录所有并发症。结果：HoLEP 组术后 2 年 AUA SS 显着改善（1.7 vs. 3.9，p < 0.0001），3 年时相似（2.7 vs. 3.3，p = 0.17）。 HoLEP 患者术后 2 年（5.6 vs. 19.9 ml，p < 0.001）和 3 年（8.4 vs. 20.2 ml，p = 0.012）PVR 体积显着改善。 HoLEP 组和 TURP 组术后 2 年（28.0 vs. 29.1 ml/s，p = 0.83）和 3 年（29.0 vs. 27.5 ml/s，p = 0.41）时的 Q(max) 相似。晚期并发症包括尿道狭窄、膀胱颈挛缩和前列腺肥大复发； HoLEP 组的再手术率为 7.2%，TURP 组的再手术率为 6.6%（p = 1.0）。结论：经过 2 年和 3 年的随访，HoLEP 排尿结果优于 TURP。晚期并发症同样低。 HoLEP 可能是 TURP 的真正替代方案。 (c) 2007 年欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。
Objectives: To report 3-yr follow-up results of a randomised clinical trial comparing holmium laser enucleation of the prostate (HoLEP) with transurethral resection of the prostate (TURP).Methods: A total of 200 patients with urodynamic obstruction and a prostate volume of less than 100 cc were prospectively randomised and assigned to HoLEP or TURP. All patients were assessed preoperatively and followed at 1, 6, 12, 18, 24, and 36 mo postoperatively. American Urological Association Symptom Score (AUA SS), maximum flow rate (Q(max)), and postvoid residual (PVR) [urine] volume were obtained at each follow-up. Perioperative data and postoperative outcome were compared. All complications were recorded.Results: AUA SS were significantly better 2 yr postoperatively in the HoLEP group (1.7 vs. 3.9, p < 0.0001) and similar at 3 yr (2.7 vs. 3.3, p = 0.17). PVR volume was significantly better 2 yr (5.6 vs. 19.9 ml, p < 0.001) and 3 yr (8.4 vs. 20.2 ml, p = 0.012) postoperatively in HoLEP patients. Q(max) was similar in the HoLEP and TURP groups at 2 yr (28.0 vs. 29.1 ml/s, p = 0.83) and at 3 yr (29.0 vs. 27.5 ml/s, p = 0.41) postoperatively. Late complications consisted of urethral strictures, bladder-neck contractures, and BPH recurrence; reoperation rates were 7.2% in the HoLEP and 6.6% in the TURP group (p = 1.0).Conclusions: After 2 and 3 yr of follow-up, HoLEP micturition outcomes compare favourably with TURP. Late complications are equally low. HoLEP may be a real alternative to TURP. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.