摘要
目的通过Meta分析比较铥激光前列腺剜除术(ThULEP)与钬激光前列腺切除术(HoLEP)治疗良性前列腺增生(BPH)的疗效和安全性。方法计算机检索PubMed、Embase、Cochrane Library、中国知网、万方等数据库,收集比较ThULEP和HoLEP治疗BPH的随机对照试验及对照临床试验,检索时限从2010年1月1日-2022年5月30日,由两位研究者独立进行文献的筛选、评价和数据提取,所有分歧均由第3位研究者解决,采用RevMan 5.4软件进行统计学分析。结果共纳入7项研究共1726例患者,其中ThULEP组750例,HoLEP组976例;Meta结果显示,与HoLEP组相比,ThULEP组留置导尿时间[MD=-0.10,95%CI(-0.17~-0.03),P=0.004]、住院时间[MD=-0.43,95%CI(-0.60~-0.25),P<0.00001]更短,术后12个月IPSS评分更低[MD=-1.13,95%CI(-1.95~-0.30),P=0.007]、术后12月QoL评分更低[MD=-1.00,95%CI(-1.19~-0.81),P<0.001],需要输血的患者更少[OR=0.11,95%CI(0.03~0.36),P=0.0003],发生尿失禁的概率更低[OR=0.24,95%CI(0.09~0.66),P=0.006]。结论ThULEP相较于HoLEP在治疗BPH上可能具有类似的疗效及安全性,并在某些方面更具有优势。
Objective To compare the efficacy and safety of thulium laser enucleation of the prostate(ThULEP)and holmium laser enucleation of the prostate(HoLEP)in the treatment of benign prostatic hyperplasia(BPH).Methods Randomized controlled trials(RCTs)and clinical controlled trials(CCTs)were searched in PubMed,Embase,Cochrane Library,CNKI and Wanfang Database from Jan.1,2010 to May 30,2022.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies.All divergences were resolved by a third researcher.RevMan 5.4 software was used for Meta analysis.Results A total of 7 studies were included,involving 1726 patients,750 in the ThULEP group and 976 in the HoLEP group.Meta analysis showed that,compared with HoLEP group,the ThULEP group had shorter catheter indwelling time[MD=-0.10,95%CI(-0.17--0.03),P=0.004],shorter hospital stay[MD=-0.43,95%CI(-0.60--0.25),P<0.00001],lower IPSS score 12 months after surgery[MD=-1.13,95%CI(-1.95--0.30),P=0.007],lower QoL score 12 months after surgery[MD=-1.00,95%CI(-1.19--0.81),P<0.001],lower transfusion rate[OR=0.11,95%CI(0.03-0.36),P=0.0003]and lower incidence of urinary incontinence[OR=0.24,95%CI(0.09-0.66),P=0.006].Conclusion ThULEP may have similar efficacy and safety as HoLEP in the treatment of BPH,and has more advantages in some aspects.
作者
周英豪
余皖东
马杭彬
张雪虎
周程
施国伟
ZHOU Yinghao;YU Wandong;Ma Hangbin;ZHANG Xuehu;ZHOU Cheng;SHI Guowei(Department of Urology,The Fifth People's Hospital of Shanghai,Fudan University,Shanghai 200240,China)
出处
《现代泌尿外科杂志》
CAS
2023年第9期764-769,共6页
Journal of Modern Urology
基金
上海市重点专科基金项目(No.ZK2019A03)。
关键词
铥激光前列腺剜除术
钬激光前列腺切除术
良性前列腺增生
META分析
系统评价
thulium laser enucleation of the prostate
holmium laser enucleation of the prostate
benign prostatic hyperplasia
Meta analysis
systematic review
