Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplas...Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia （BPH） and to evaluate their clinical and voiding outcome. Methods： A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score （IPSS）, quality of life score （QoL）, uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results： All patients got through the perioperative period safely. The chief advantages of PVP were： short operative time （25.6 ± 7.6 min）, little bleeding loss （56.8 ± 14.3 mL） and short indwelling catheterization （1.6 ± 0.8 d）. The IPSS and QoL decreased from （29.6 ± 5.4） and （5.4 ± 0.6） to （9.5 ± 2.6） and （1.3 ± 0.6）, respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data （P 〈 0.05）. No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion： PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.展开更多
This study sought to evaluate the efficacy and safety of photoselective vaporisation （PVP） vs. transurethral resection of the prostate （TURP） for patients with benign prostatic hyperplasia （BPH）. Eligible studie...This study sought to evaluate the efficacy and safety of photoselective vaporisation （PVP） vs. transurethral resection of the prostate （TURP） for patients with benign prostatic hyperplasia （BPH）. Eligible studies were identified from electronic databases （Cochrane Library, PubMed and EMBASE）. The database search, quality assessment and data extraction were performed independently by two reviewers. Efficacy （primary outcomes： maximum urinary flow rate （Qmax）, international prostate symptom score （IPSS）, postvoid residual urine （PVR） and quality of life （QoL）; secondary outcomes： operative time, hospital time and catheter removal time） and safety （complications, such as transfusion and capsular perforation） were explored by using Review Manager 5.0. Six randomized controlled trials （RCTs） and five case-controlled studies of 1398 patients met the inclusion criteria. A meta-analysis of the extractable data showed that there were no differences in I PSS, Qmax, QoL or PVR between PVP and TU RP （mean difference （MD）： prostate sizes 〈 70 ml, Qmax at 24 months, MD=0.01, P=0.97; IPSS at 12 months, MD=0.18, P=0.64; QoL at 12 months, MD=-0.00, P=0.96; PVR at 12 months, MD=0.52, P=0.43; prostate sizes 〉70 ml, Qmax at 6 months, MD=-3.46, P=0.33; IPSS at 6 months, MD=3.11, P=0o36; PVR at 6 months, MD=25.50,P=-0.39）. PVP was associated with a shorter hospital time and catheter removal time than TURP, whereas PVP resulted in a longer operative time than TURP. For prostate sizes 〈70 ml, there were fewer transfusions, capsular perforations, incidences of TUR syndrome and clot retentions following PVP compared with TURP. These results indicate that PVP is as effective and safe as TURP for BPH at the mid-term patient follow-up, in particular for prostate sizes 〈70 ml. Due to the different energy settings available for green-light laser sources and the higher efficiency and performance of higher-quality lasers, large-sample, long-term RCTs are required to verify whether展开更多
Photo-assisted SCR(PSCR) offers a potential solution for removal of NO at room temperature. MnTiO_(x)as PSCR catalyst exhibits superior performance with NO removal of 100% at the room temperature. Electron paramagneti...Photo-assisted SCR(PSCR) offers a potential solution for removal of NO at room temperature. MnTiO_(x)as PSCR catalyst exhibits superior performance with NO removal of 100% at the room temperature. Electron paramagnetic resonance(EPR) analysis revealed the presence of numerous oxygen vacancies on MnTiO_(x). Optical carrier density functional theory(DFT) calculations showed that the threedimensional orbital hybridization of Mn and Ti is significantly enhanced under light irradiation. The MnTiO_(x)catalyst exhibited excellent electron–hole separation ability, which can adsorbe NH_(3)and dissociate to form NH_(2)fragments and H atoms. In-situ diffuse reflectance infrared fourier-transform spectroscopy(DRIFTS) indicated that the optical carrier enhanced NH_(3)adsorption on MnTiO_(x), which makes it possess excellent PSCR activity. This work provided an additional strategy to NO removal with PSCR catalysts and showed potential for use in photocatalysis.展开更多
Aim:To explore the feasibility and safely of greenlight photoselective vaporization of the prostate(PVP)on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH...Aim:To explore the feasibility and safely of greenlight photoselective vaporization of the prostate(PVP)on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH)and to evalu- ate their clinical and voiding outcome.Methods:A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80W potassium-titanyl-phosphate laser,which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope.Operative time,blood loss,indwelling catheterzation,international prostate symptom score(IPSS),quality of life score(QoL),uroflowmetry,postvoid residual urine volume and short-term complication rates were evaluated for all patients.Results:All patients got through the perioperative period safely.The chief advantages of PVP were:short operative time(25.6±7.6min),little bleeding loss(56.8±14.3mL)and short indwelling catheterization(1.6±0.8d).The IPSS and QoL decreased from(29.6±5.4)and(5.4±0.6)to(9.5±2.6)and(1.3± 0.6),respectively.The vast majority of patients were satisfied with voiding outcome.The mean maximal urinary flow rate increased to 17.8 roLls and postvoid residual urine volume decreased to 55.6mL.These results are signifi- cantly different from preoperative data(P<0.05).No patient required blood transfusion or fluid absorption.There were few complications and very high patient satisfaction after operation.Conclusion:PVP has a short operative time and high tolerance,and is safe,effective and minimally invasive for high-risk patients,therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.展开更多
Objective:Photoselective vaporization of the prostate(PVP)is a widely performed surgical procedure for benign prostatic obstruction.This approach has become particular favoured for men on anti-platelet and anticoagula...Objective:Photoselective vaporization of the prostate(PVP)is a widely performed surgical procedure for benign prostatic obstruction.This approach has become particular favoured for men on anti-platelet and anticoagulation agents such as clopidogrel and warfarin but there is minimal published experience in the setting of novel oral anticoagulants(NOACs).This study was to examine the perioperative outcomes in men on NOACs undergoing PVP,with particular reference to perioperative morbidity.Methods:A retrospective analysis of PVP datasets was undertaken from three centres in Sydney(Australia),Toulouse(France)and Boston(USA).Subjects who had been treated whilst on NOACs without discontinuation or bridging were identified.Perioperative outcomes and treatment parameters were examined and morbidity recorded according to Clavien-Dindo(CD)classification.Results:There were a total of 20 subjects who had undergone PVP whilst NOACs had been continued during the perioperative period.The mean age was 776.5 years.The mean prostate volume,energy utilization and vaporisation time was 9456 mL,301211 kJ,and 3521 min respectively.The mean postoperative duration of catheterization and duration of hospitalization was 2.22.4 days and 2.42.4 days respectively.There was a single episode of urinary tract infection and four subjects required re-catheterisation for non-hematuric retentions.Conclusions:This study supports the safety of men on NOACs undergoing PVP.Whilst this study represents the largest experience of PVP in these men,larger studies are necessary to confirm the safety of PVP in this group of men undergoing BPH-related surgery.展开更多
目的探讨经尿道绿激光前列腺汽化术(photoselective vaporization of the prostate,PVP)、经尿道前列腺等离子剜除术(transurethra plasma kinetic enucleation of the prostate,PKEP)、经尿道前列腺等离子双极电切术(transurethra plas...目的探讨经尿道绿激光前列腺汽化术(photoselective vaporization of the prostate,PVP)、经尿道前列腺等离子剜除术(transurethra plasma kinetic enucleation of the prostate,PKEP)、经尿道前列腺等离子双极电切术(transurethra plasma kinetic resection of the prostate,PKRP)在高龄高危前列腺增生症(benign prostatic hyperplasia,BPH)患者中的应用价值。方法240例高龄高危BPH患者被随机分为A、B、C组,每组各80例。A、B、C组分别采用PVP、PKEP和PKRP进行治疗。比较3组患者的围手术期指标、应激反应指标、炎症因子浓度、并发症、国际前列腺症状评分、生活质量评分、最大尿流率和残余尿量。结果在手术时间、术中失血量、留置尿管时间、膀胱冲洗时间、术后住院时间方面,A组最优,B组次之,C组最差(P<0.05)。术后1 d的Cor、NE、E、FBG、IL-6、IL-2、IL-1β、TNF-α浓度以A组最低,B组次之,C组最高(P<0.05)。A组的短暂性尿失禁发生率明显低于B组(P<0.0125)。结论在围手术期指标、应激反应和全身炎症反应方面,PVP最优,PKEP次之,PKRP最差,但3中术式的近期效果无差别,其中PKEP的短暂性尿失禁发生率较高。展开更多
目的:对比经尿道选择性绿激光前列腺汽化术(photoselective vaporization of prostate,PVP)与经尿道前列腺电切术(transurethral resection of prostate,TURP)治疗良性前列腺增生症(benign prostate hyperplasia,BPH)的安全性及有效性...目的:对比经尿道选择性绿激光前列腺汽化术(photoselective vaporization of prostate,PVP)与经尿道前列腺电切术(transurethral resection of prostate,TURP)治疗良性前列腺增生症(benign prostate hyperplasia,BPH)的安全性及有效性。方法:按Cochrane系统评价方法,计算机检索Cochrane library、Medline、Embase、CNKI、CBM、万方、维普等文献资料库;手工检索中文泌尿外科期刊的相关文献。收集对比PVP及TURP治疗BPH的随机对照试验,质量评价后采用RevMan 5.0软件进行Meta分析。结果:共纳入5个符合要求的RCT研究,共528例患者。Meta分析结果显示:(1)有效性方面:PVP及TURP治疗BPH,术后6个月国际前列腺症状评分、生活质量、最大尿流率和残余尿量指标差异均无统计学意义(P>0.05)。(2)安全性方面:与TURP相比,PVP手术时间较长[MD=28.97,95%CI(9.72,48.21)],术后留置导尿时间短[MD=-2.86,95%CI(-4.58,-1.13)],住院时间较短[MD=-2.32,95%CI(-2.79,-1.85)],术中输血较少[OR=0.08,95%CI(0.02,0.34)],术后尿道狭窄率无显著差异[OR=0.74,95%CI(0.27,2.07)]。结论:PVP与TURP均能显著改善轻、中度前列腺增生患者的症状,具有相似的临床疗效。与TURP相比,PVP操作更安全,术后留置导尿时间及住院时间更短;术后尿道狭窄发生率方面两种术式无显著差异。展开更多
文摘Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia （BPH） and to evaluate their clinical and voiding outcome. Methods： A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score （IPSS）, quality of life score （QoL）, uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results： All patients got through the perioperative period safely. The chief advantages of PVP were： short operative time （25.6 ± 7.6 min）, little bleeding loss （56.8 ± 14.3 mL） and short indwelling catheterization （1.6 ± 0.8 d）. The IPSS and QoL decreased from （29.6 ± 5.4） and （5.4 ± 0.6） to （9.5 ± 2.6） and （1.3 ± 0.6）, respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data （P 〈 0.05）. No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion： PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.
文摘This study sought to evaluate the efficacy and safety of photoselective vaporisation （PVP） vs. transurethral resection of the prostate （TURP） for patients with benign prostatic hyperplasia （BPH）. Eligible studies were identified from electronic databases （Cochrane Library, PubMed and EMBASE）. The database search, quality assessment and data extraction were performed independently by two reviewers. Efficacy （primary outcomes： maximum urinary flow rate （Qmax）, international prostate symptom score （IPSS）, postvoid residual urine （PVR） and quality of life （QoL）; secondary outcomes： operative time, hospital time and catheter removal time） and safety （complications, such as transfusion and capsular perforation） were explored by using Review Manager 5.0. Six randomized controlled trials （RCTs） and five case-controlled studies of 1398 patients met the inclusion criteria. A meta-analysis of the extractable data showed that there were no differences in I PSS, Qmax, QoL or PVR between PVP and TU RP （mean difference （MD）： prostate sizes 〈 70 ml, Qmax at 24 months, MD=0.01, P=0.97; IPSS at 12 months, MD=0.18, P=0.64; QoL at 12 months, MD=-0.00, P=0.96; PVR at 12 months, MD=0.52, P=0.43; prostate sizes 〉70 ml, Qmax at 6 months, MD=-3.46, P=0.33; IPSS at 6 months, MD=3.11, P=0o36; PVR at 6 months, MD=25.50,P=-0.39）. PVP was associated with a shorter hospital time and catheter removal time than TURP, whereas PVP resulted in a longer operative time than TURP. For prostate sizes 〈70 ml, there were fewer transfusions, capsular perforations, incidences of TUR syndrome and clot retentions following PVP compared with TURP. These results indicate that PVP is as effective and safe as TURP for BPH at the mid-term patient follow-up, in particular for prostate sizes 〈70 ml. Due to the different energy settings available for green-light laser sources and the higher efficiency and performance of higher-quality lasers, large-sample, long-term RCTs are required to verify whether
基金supported by Science and Technology Innovation Talents Program of Bingtuan (No.2019CB025)Major Scientific and Technological Project of Bingtuan (No.2018AA002)Project of Regional Innovation in Bingtuan (No.2021BB005)。
文摘Photo-assisted SCR(PSCR) offers a potential solution for removal of NO at room temperature. MnTiO_(x)as PSCR catalyst exhibits superior performance with NO removal of 100% at the room temperature. Electron paramagnetic resonance(EPR) analysis revealed the presence of numerous oxygen vacancies on MnTiO_(x). Optical carrier density functional theory(DFT) calculations showed that the threedimensional orbital hybridization of Mn and Ti is significantly enhanced under light irradiation. The MnTiO_(x)catalyst exhibited excellent electron–hole separation ability, which can adsorbe NH_(3)and dissociate to form NH_(2)fragments and H atoms. In-situ diffuse reflectance infrared fourier-transform spectroscopy(DRIFTS) indicated that the optical carrier enhanced NH_(3)adsorption on MnTiO_(x), which makes it possess excellent PSCR activity. This work provided an additional strategy to NO removal with PSCR catalysts and showed potential for use in photocatalysis.
文摘Aim:To explore the feasibility and safely of greenlight photoselective vaporization of the prostate(PVP)on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH)and to evalu- ate their clinical and voiding outcome.Methods:A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80W potassium-titanyl-phosphate laser,which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope.Operative time,blood loss,indwelling catheterzation,international prostate symptom score(IPSS),quality of life score(QoL),uroflowmetry,postvoid residual urine volume and short-term complication rates were evaluated for all patients.Results:All patients got through the perioperative period safely.The chief advantages of PVP were:short operative time(25.6±7.6min),little bleeding loss(56.8±14.3mL)and short indwelling catheterization(1.6±0.8d).The IPSS and QoL decreased from(29.6±5.4)and(5.4±0.6)to(9.5±2.6)and(1.3± 0.6),respectively.The vast majority of patients were satisfied with voiding outcome.The mean maximal urinary flow rate increased to 17.8 roLls and postvoid residual urine volume decreased to 55.6mL.These results are signifi- cantly different from preoperative data(P<0.05).No patient required blood transfusion or fluid absorption.There were few complications and very high patient satisfaction after operation.Conclusion:PVP has a short operative time and high tolerance,and is safe,effective and minimally invasive for high-risk patients,therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.
文摘Objective:Photoselective vaporization of the prostate(PVP)is a widely performed surgical procedure for benign prostatic obstruction.This approach has become particular favoured for men on anti-platelet and anticoagulation agents such as clopidogrel and warfarin but there is minimal published experience in the setting of novel oral anticoagulants(NOACs).This study was to examine the perioperative outcomes in men on NOACs undergoing PVP,with particular reference to perioperative morbidity.Methods:A retrospective analysis of PVP datasets was undertaken from three centres in Sydney(Australia),Toulouse(France)and Boston(USA).Subjects who had been treated whilst on NOACs without discontinuation or bridging were identified.Perioperative outcomes and treatment parameters were examined and morbidity recorded according to Clavien-Dindo(CD)classification.Results:There were a total of 20 subjects who had undergone PVP whilst NOACs had been continued during the perioperative period.The mean age was 776.5 years.The mean prostate volume,energy utilization and vaporisation time was 9456 mL,301211 kJ,and 3521 min respectively.The mean postoperative duration of catheterization and duration of hospitalization was 2.22.4 days and 2.42.4 days respectively.There was a single episode of urinary tract infection and four subjects required re-catheterisation for non-hematuric retentions.Conclusions:This study supports the safety of men on NOACs undergoing PVP.Whilst this study represents the largest experience of PVP in these men,larger studies are necessary to confirm the safety of PVP in this group of men undergoing BPH-related surgery.
文摘目的探讨经尿道绿激光前列腺汽化术(photoselective vaporization of the prostate,PVP)、经尿道前列腺等离子剜除术(transurethra plasma kinetic enucleation of the prostate,PKEP)、经尿道前列腺等离子双极电切术(transurethra plasma kinetic resection of the prostate,PKRP)在高龄高危前列腺增生症(benign prostatic hyperplasia,BPH)患者中的应用价值。方法240例高龄高危BPH患者被随机分为A、B、C组,每组各80例。A、B、C组分别采用PVP、PKEP和PKRP进行治疗。比较3组患者的围手术期指标、应激反应指标、炎症因子浓度、并发症、国际前列腺症状评分、生活质量评分、最大尿流率和残余尿量。结果在手术时间、术中失血量、留置尿管时间、膀胱冲洗时间、术后住院时间方面,A组最优,B组次之,C组最差(P<0.05)。术后1 d的Cor、NE、E、FBG、IL-6、IL-2、IL-1β、TNF-α浓度以A组最低,B组次之,C组最高(P<0.05)。A组的短暂性尿失禁发生率明显低于B组(P<0.0125)。结论在围手术期指标、应激反应和全身炎症反应方面,PVP最优,PKEP次之,PKRP最差,但3中术式的近期效果无差别,其中PKEP的短暂性尿失禁发生率较高。
