目的:比较围手术期,功能,和使用倾向评分(PS)匹配分析的单一外科医生进行的thulium光纤激光前列腺摘除(ThuFLEP)和双极前列腺摘除之间的安全性结果。
方法:数据来自675例患者,其中422人由一名经验丰富的外科医生进行ThuFLEP和双极眼球摘除。用FiberlaseU1(IREPolusLtd.)进行ThuFLEP。围手术期参数,安全,和功能结果,如国际前列腺症状评分(IPSS),生活质量(QoL),后空隙残余体积(PVR),和最大尿流率(Qmax)进行评估。要控制选择偏差,使用以下变量作为协变量进行1:1PS匹配分析:总前列腺体积,术前IPSS和早期括约肌释放。
结果:在422名患者中,370例(87.7%)接受ThuFLEP,52例(12.3%)接受双极摘除。操作,摘除,PS匹配分析前后各组间的分块时间具有可比性(分别为p=0.954,p=0.474,p=0.362).功能参数(IPSS、QoL,PVR,Qmax)在PS匹配之前和之后的每个时间点在组间也是相当的。IPSS的重大改进,QoL评分,Qmax,在24个月的随访期间,ThuFLEP和双极眼球摘除术均观察到PVR,组间无任何显着差异。PS匹配分析前后术后早期和晚期并发症相似。
结论:ThuFLEP在围手术期特征方面与双极眼球摘除术相当,排泄参数的改进,和并发症发生率。两种方法均被证明在良性前列腺增生的治疗中有效且安全。
OBJECTIVE: To compare perioperative, functional, and safety outcomes between thulium fiber laser enucleation of the prostate (ThuFLEP) and bipolar enucleation of the prostate performed by a single surgeon with use of propensity score (PS)-matched analysis.
METHODS: Data were from 675 patients, 422 of whom underwent ThuFLEP and bipolar enucleation by a single highly experienced surgeon. ThuFLEP was performed with Fiberlase U1 (IRE Polus Ltd.). Perioperative parameters, safety, and functional outcomes, such as International Prostate Symptom Score (IPSS), quality of life (QoL), postvoid residual volume (PVR), and maximum urinary flow rate (Qmax) were assessed. To control for selection bias, a 1:1 PS-matched analysis was carried out using the following variables as covariates: total prostate volume, preoperative IPSS and early sphincter release.
RESULTS: Of 422 patients, 370 (87.7%) underwent ThuFLEP and 52 (12.3%) underwent bipolar enucleation. Operation, enucleation, and morcellation time were comparable between groups before and after PS-matched analysis (p=0.954, p=0.474, p=0.362, respectively). Functional parameters (IPSS, QoL, PVR, Qmax) were also comparable between groups at every time point before and after PS matching. Significant improvements in IPSS, QoL score, Qmax, and PVR were observed during the 24-month follow-up period for both ThuFLEP and bipolar enucleation without any significant differences between groups. Early and late postoperative complications before and after PS-matched analysis were similar.
CONCLUSIONS: ThuFLEP was comparable to bipolar enucleation in perioperative characteristics, improvement in voiding parameters, and complication rates. Both procedures were shown to be effective and safe in the management of benign prostatic hyperplasia.