三种经尿道前列腺手术对前列腺增生患者近期疗效的比较分析

doi:10.19558/j.cnki.10-1020/r.2020.06.012

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摘要 目的： 探讨经尿道前列腺钬激光剜除术（HoLEP）与经尿道前列腺电切术（TURP）和经尿道双极等离子前列腺剜除术（PKEP）对良性前列腺增生（BPH）患者治疗效果上的差异。方法： 选取2017年7月–2019年6月就诊的150例患者,按手术方式均分为三组：HoLEP组、TURP组及PKEP组。比较各组患者术前、围术期及术后随访期（1、3、6个月）的膀胱剩余尿量（PVR）、最大尿流率（Q_max）、国际前列腺症状评分表（IPSS）、生活质量评分（QOL）等指标。结果： 三组患者术前基线资料差异无统计学意义（P>0.05）。三组患者平均住院日、术后Q_max、PVR、IPSS评分和QOL评分均较术前有显著改善（P<0.05）,其中HoLEP组术后改善幅度最大。且与TURP及PKEP相比,HoLEP组术后的血红蛋白量及血清钠水平没有明显降低（P>0.05）。结论： HoLEP治疗BPH术后膀胱冲洗时间、尿管留置时间及平均住院日均较TURP及PKEP短,具有更好的近期疗效。

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	罗杰鑫
	卢远生
	方少伟
	莫汝均
	陆奔
	张志刚
	米其武

关键词 ：良性前列腺增生, 钬激光, 等离子, 前列腺剜除术, 近期疗效

Abstract：Objective： To investigate the difference in the treatment efficacy of transurethral holmium laser enucleation of prostate （HoLEP）, transurethral resection of prostate （TURP） and transurethral bipolar plasma enucleation of prostate （PKEP） for patients with benign prostatic hyperplasia （BPH）. Methods： A total of 150 patients in our hospital from July 2017 to June 2019 were selected and randomly divided into three groups, including HoLEP group, TURP group and PKEP group, with 50 cases in each group. We compared the indicators of the three groups of patients before surgery, perioperation and postoperative follow-up （1 month, 3 months and 6 months）, such as bladder residual urine volume （PVR）, maximum urine flow rate （Q_max）, International Prostate Symptom Score （IPSS）, Quality of Life Score （QOL）. Results： There was no statistically significant difference in the preoperative characteristics among the HoLEP group, TURP group and PKEP group （P > 0.05）. Compared with preoperation, the indicators of the three groups, such as average hospital stay, weight of prostate removed, Q_max, PVR, IPSS score and QOL score, were significantly improved after the operation （P < 0.05）, and the HoLEP group had the largest improvement after surgery. Moreover, postoperative serum hemoglobin and sodium levels in HoLEP group did not significantly decrease as compared with TURP and PKEP. Conclusion： The present study verified the better short-term efficacy of HoLEP in treating patients with BPH, as HoLEP had shorter bladder irrigation and catheterization time and hospital stay than TURP and PKEP.

Key words： holmium laser plasmakinetic enucleation of prostate short-term efficacy

收稿日期: 2020-11-13

ZTFLH:

R697

基金资助:东莞市社会科技发展（重点）项目（201750715001460）

通讯作者: 米其武,mqw175@163.com

引用本文:

罗杰鑫, 卢远生, 方少伟, 莫汝均, 陆奔, 张志刚, 米其武. 三种经尿道前列腺手术对前列腺增生患者近期疗效的比较分析[J]. 微创泌尿外科杂志, 2020, 9(6): 415-420.
LUO Jiexin, LU Yuansheng, FANG Shaowei, MO Rujun, LU Ben, ZHANG Zhigang, MI Qiwu. Comparative analysis of short-term curative effect of HoLEP, TURP and PKEP for patients with benign prostatic hyperplasia. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(6): 415-420.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1640.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I6/415

[1] GANG W, HONG Z, CHAO L, et al.A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up. Lasers Med Sci, 2016,31(4):599-604.
[2] ABOU-TALEB A, EL-SHAER W, KANDEEL W, et al.Bipolar plasmakineticenucleoresection of the prostate: our experience with 245 patients for 3 years of follow-up. J Endourol, 2017,31(3): 300-306.
[3] SAMIR M, TAWFICK A, MAHMOUD M, et al.Two-year follow-up in bipolar transurethral enucleation and resection of the prostate in comparison with bipolar transurethral resection of the prostate in treatment of large prostates. Randomized Controlled Trial. Urology, 2019,133(133):192-198.
[4] QIAN X, LIU H, XU D, et al.Functional outcomes and complications following B-TURP versus HoLEP for the treatment of benign prostatic hyperplasia: a review of the literature and Meta-analysis. Aging Male, 2017,20(3):184-191.
[5] ZHAO Z, MA W, XUAN X, et al.Impact of plasmakinetic enucleation of the prostate (PKEP) on sexual function: results of a prospective trial. J Sex Med, 2012,9(5):1473-1481.
[6] XU PENG, XU ABAI, CHEN BINSHEN, et al.Bipolar transurethral enucleation and resection of the prostate: Whether it is ready to supersede TURP? Asian J Urol, 2018,5(1):48-54.
[7] ZHAO Z, ZENG G, ZHONG W, et al.A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol, 2010,58(5):752-758.
[8] BARON M, NOUHAUD FX, DELCOURT C, et al.[HoLEP learning curve: toward a standardised formation and a team strategy]. Prog Urol, 2016,26(9):492-499.
[9] ROBERT G, CORNU JN, FOURMARIER M, et al.Multicentre prospective evaluation of the learning curve of Holmium laser enucleation of the prostate (HoLEP). BJU Int, 2016,117(3):495-499.
[10] MCVARY KT, ROEHRBORN CG, AVINS AL, et al.Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol, 2011,185(5):1793-1803.
[11] FENG L, ZHANG D, TIAN Y, et al.Thulium laser enucleation versus plasmakinetic enucleation of the prostate: a randomized trial of a single center. J Endourol, 2016,30(6): 665-670.
[12] CHEN SS, LIN MJ, WENG MF, et al.Influence of prostate size on the perioperative and postoperative outcome of transurethral plasmakinetic enucleation of the prostate: Results of 892 patients with 3 years of follow-up. KaohsiungJ Med Sci, 2018,34(10):576-582.
[13] WANG SJ, MU XN, CHEN J, et al.Plasmakinetic enucleation of prostate versus 160-W laserphotoselective vaporization for the treatment of benign prostatic hyperplasia. Asian J Androl, 2017,19(1): 15-19.
[14] ROSENHAMMER B, LAUSENMEYER EM, MAYR R, et al.HoLEP provides a higher prostate cancer detection rate compared to bipolar TURP: a matched-pair analysis. World J Urol, 2018,36(12):2035-2041.
[15] RAPISARDA S, RUSSO GI, OSMAN NI, et al.The use of laser as a therapeutic modality as compared to TURP for the small prostate ≤40 mL: a collaborative review. Minerva Urol Nefrol, 2019,71(6):569-575.
[16] CHEN YB, XU H, XU H, et al.Comparison of plasmakinetic enucleation of the prostate with holmium laser enucleation of the prostate in the treatment of benign prostate hyperplasia. Int J Clin Exp Med, 2016,9(6):7328-7333.
[17] LUO YH, SHEN JH, GUAN RY, et al.Plasmakinetic enucleation of the prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: comparison of outcomes according to prostate size in 310 patients. Urology, 2014,84(4):904-910.
[18] HERRMANN TRW.[Long-term outcome after endoscopic enucleation of the prostate: From monopolar enucleation to HoLEP and from HoLEP to EEP]. Urologe A, 2016,55(11):1446-1454.
[19] SUN J, SHI A, TONG Z, et al.Safety and feasibility study of Holmium laser enucleation of the prostate (HOLEP) on patients receiving dual antiplatelet therapy (DAPT). World J Urol, 2018,36(2):271-276.
[20] 王建文,张孟冬,平浩,等.前列腺等离子剜切术和钬激光剜除术治疗良性前列腺增生疗效分析.中华男科学杂志,2018,24(12):1084-1088.
[21] 闻竹,马成民,张超,等.经尿道钬激光前列腺剜除术与前列腺电切术近期疗效的对比分析.现代泌尿外科杂志,2014,19(4):230-232,236.
[22] NAIR SM, PIMENTEL MA, GILLING PJ,et al.A review of laser treatment for symptomatic bph(benign prostatic hyperplasia). CurrUrol Rep, 2016,17(6):45.