背景:我们进行了这项队列研究,以评估MRI定量测量下双极前列腺经尿道等离子摘除术(B-TUEP)与前列腺周围区厚度(PZT)相关的学习曲线的差异。
方法:对于研究,60例良性前列腺增生(BPH)患者受累。PZT定义为“薄”(<7mm),“厚”(>10mm),和“中”(介于两者之间),每组20名患者。学习阶段被定义为第1组(编号1-20),第2组(编号21-40),和第3组(编号41-60).我们测量了前列腺的参数,如PZT和过渡区厚度(TZT),MRI。没有摘除经验的学习者执行了这些操作。进行统计分析以比较差异。Pearson相关分析和多元线性回归分析评价了患者特征之间的关系。P<0.05被认为具有统计学意义。
结果:单向方差分析显示不同的去核效率(0.811±0.18vs.0.748±0.14vs.0.634±0.16),前列腺体积(58.9±15.33vs.57.3±15.58vs.46.6±14.10),和过渡区厚度(44.45±7.60vs.42.45±6.08vs.34.78±6.04)在薄中,中等,和浓密的群体。按学习阶段划分的各组之间的摘除效率不同(第1组与第3组,0.658vs.0.783;第2组vs.第3组,0.751vs.0.783).Pearson相关分析显示PZT与前列腺体积呈负相关(r=-0.427),切除重量(r=-0.35),眼球摘除效率(r=-0.445),和TZT(r=-0.533),与Q-max(r=0.301)和膀胱出口梗阻指数(BOOI)(r=0.388)呈正相关。PZT的回归系数,TZT,前列腺体积,Q-max分别为-0.012、0.008、0.007和0.013(均P<0.05)。
结论:较低的PZT与较高的摘除效率无关,较大的腺瘤,更高的TZT。PZT可能是B-TUEP学习曲线的重要因素。TZT较高,前列腺体积。和Q-max也可以涉及更高的去核效率。对于B-TUEP学习者,当PZT低时,执行操作似乎更容易,尽管胶囊穿孔应该更加小心。Further,如果PZT较高,则应更注意保持胶囊平面。
BACKGROUND: We conducted this cohort study to assess the differences in the learning curve of bipolar transurethral plasma enucleation of the prostate (B-TUEP) associated with prostatic peripheral zone thickness (PZT) under MRI quantitative measurements.
METHODS: For the study, 60 patients with benign prostatic hyperplasia (BPH) were involved. PZT are defined as \"Thin\" (<7 mm), \"Thick\" (>10 mm), and \"Medium\" (in between), with 20 patients in each group. Learning stages were defined as Group 1 (No. 1-20), Group 2 (No. 21-40), and Group 3 (No. 41-60). We measured parameters of the prostate, such as PZT and transitional zone thickness (TZT), with MRI. A learner with no experience in enucleation performed the operations. Statistical analyses were performed to compare the differences. Pearson correlation analysis and multiple linear regression analysis evaluated the relationship between characteristics of patients. P < 0.05 was deemed statistically significant.
RESULTS: One-Way ANOVA revealed different enucleation efficiency (0.811 ± 0.18 vs. 0.748 ± 0.14 vs. 0.634 ± 0.16), prostate volume (58.9 ± 15.33 vs. 57.3 ± 15.58 vs. 46.6 ± 14.10), and thickness of transition zone (44.45 ± 7.60 vs. 42.45 ± 6.08 vs. 34.78 ± 6.04) among Thin, Medium, and Thick groups. The enucleation efficiency is different between groups divided by learning stages (Group 1 vs. Group 3, 0.658 vs. 0.783; Group 2 vs. Group 3, 0.751 vs. 0.783). Pearson correlation analysis reveals that PZT was negatively correlated with prostate volume (r = -0.427), resection weight (r = -0.35), enucleation efficiency (r = -0.445), and TZT (r = -0.533), and was positively correlated with Q-max (r = 0.301) and bladder outlet obstruction index (BOOI) (r = 0.388). The regression coefficients of PZT, TZT, prostate volume, and Q-max were -0.012, 0.008, 0.007, and 0.013, respectively (all P < 0.05).
CONCLUSIONS: Lower PZT is independent of higher enucleation efficiency, larger adenoma, and higher TZT. PZT may be an important factor on the learning curve of B-TUEP. Higher TZT, prostate volume. and Q-max may also relate to higher enucleation efficiency. For B-TUEP learners, it seems easier to perform the operation when the PZT is low, though more care should be taken with the capsule perforation. Further, the capsule plane should be maintained more attentively if the PZT is high.