Abstract：
This meta-analysis evaluates the efficacy and safety of greenlight (PVP) and thulium laser vaporization (ThuVAP) in Benign Prostatic Hyperplasia (BPH) treatment. A systematic literature search was conducted in databases including PubMed, Cochrane Library, EMBASE, CNKI, Wangfang, and VIP in November 2023. Following the PRISMA guidelines, a systematic review and meta-analysis of the primary outcomes of interest were performed. The review was prospectively registered on PROSPERO under the registration number CRD42023491316. A total of 13 studies were included. The results of the meta-analysis showed that compared to PVP, ThuVAP had a shorter operation time (MD: 8.56, 95% CI: 4.10 ~ 13.03, p = 0.0002), and higher postoperative transfusion (OR:0.26, 95% CI: 0.10 ~ 0.64, p = 0.004). However, no significant differences were observed between the two groups in terms of length of stay (MD: -0.32, 95% CI: -0.78 ~ 0.14, p = 0.17), catherization time (MD: 0.03, 95% CI: -0.13 ~ 0.19, p = 0.73), international prostate symptom score improvement (MD: 0.23, 95% CI: -0.36 ~ 0.81, p = 0.45), quality of life improvement (MD: 0.04, 95% CI: -0.04 ~ 0.12, p = 0.29), maximum urinary flow rate improvement (MD: -0.59, 95% CI: -1.42 ~ 0.24, p = 0.16), postvoid residual urine volume improvement (MD: 1.04, 95% CI: -6.63 ~ 8.71, p = 0.79), overall postoperative complications (OR:1.15, 95% CI: 0.65 ~ 2.03, p = 0.63), postoperative bleeding (OR:1.18, 95% CI: 0.67 ~ 2.07, p = 0.56), re-peration (OR:0.55, 95% CI: 0.16 ~ 1.95, p = 0.35), urethral stricture (OR:0.90, 95% CI: 0.46 ~ 1.75, p = 0.75), and urinary incontinence (OR:1.07, 95% CI: 0.64 ~ 1.78, p = 0.80). The results of subgroup analysis showed that the results of comparing thulium vaporesection or vapoenucleation with PVP were consistent with the results of the pooled analysis. Both greenlight and thulium laser vaporization are effective and safe, with comparable surgical and functional outcomes. The choice between these methods should be based on patient-specific factors.
摘要：
这项荟萃分析评估了绿光（PVP）和thu激光汽化术（ThuVAP）在良性前列腺增生（BPH）治疗中的有效性和安全性。在包括PubMed在内的数据库中进行了系统的文献检索，科克伦图书馆,EMBASE,CNKI,王芳,和VIP在2023年11月。按照PRISMA准则，我们对感兴趣的主要结局进行了系统评价和荟萃分析.该审查已在PROSPERO上注册，注册号为CRD42023491316。共纳入13项研究。荟萃分析的结果表明，与PVP相比，ThuVAP手术时间较短(MD:8.56,95%CI:4.10~13.03,p=0.0002),术后输血量较高(OR:0.26,95%CI:0.10~0.64,p=0.004)。然而,两组间住院时间无显著差异(MD:-0.32,95%CI:-0.78~0.14,p=0.17),诱导时间(MD:0.03,95%CI:-0.13~0.19,p=0.73),国际前列腺症状评分改善（MD：0.23，95％CI：-0.36〜0.81，p=0.45），生活质量改善(MD:0.04,95%CI:-0.04~0.12,p=0.29),最大尿流率改善(MD:-0.59,95%CI:-1.42~0.24,p=0.16),残余尿量改善(MD:1.04,95%CI:-6.63~8.71,p=0.79),术后总并发症(OR:1.15,95%CI:0.65~2.03,p=0.63),术后出血(OR:1.18,95%CI:0.67~2.07,p=0.56),结果(OR:0.55,95%CI:0.16~1.95,p=0.35),尿道狭窄(OR:0.90,95%CI:0.46~1.75,p=0.75),尿失禁(OR:1.07,95%CI:0.64~1.78,p=0.80)。亚组分析的结果显示，与PVP比较the的结果与合并分析的结果一致。绿光和thulium激光汽化都是有效和安全的，具有可比的手术和功能结果。这些方法之间的选择应基于患者特异性因素。
