钬激光剜除术治疗良性前列腺增生疗效的荟萃分析

肖遥; 郝斌; 许长宝; 刘昌伟; 褚校涵; 黄垂国

doi:10.13201/j.issn.1001-1420.2018.11.009

钬激光剜除术治疗良性前列腺增生疗效的荟萃分析

- 1. 南阳市中心医院泌尿外科(河南南阳, 473000);
- 2. 郑州大学第二附属医院泌尿外科

详细信息

通讯作者: 郝斌,E-mail:binhao68@126.com

中图分类号: R697

收稿日期: 2017-06-13

Meta-analysis of the efficacy of holmium laser enucleation in the treatment of benign prostatic hyperplasia

- 1. Department of Urology, Nanyang Central Hospital, Nanyang, Henan, 473000, China;
- 2. Department of Urology, Second Affiliated Hospital of Zhengzhou University

More Information

Corresponding author: HAO Bin, E-mail: binhao68@126.com

Received Date: 13 June 2017

摘要

摘要: 目的:通过对比前列腺钬激光剜除术(HoLEP)与经尿道前列腺切除术(TURP)治疗BPH的效果,评估后者的安全性及有效性。方法:计算机检索PubMed、Embase、Cochrane Library及万方数据库,搜集HoLEP与TURP治疗BPH的临床随机对照试验,数据库更新至2017年5月。结果以均值差、相对危险度及对应的95%置信区间(CI)表达。根据Cochrane Handbook评估入选临床试验的偏倚风险。结果:纳入9篇RCTs,共1145例患者。HoLEP组575例,TURP组570例。与TURP组比较,HoLEP组手术时间长[WMD=22.82,95% CI (14.04,31.59),P<0.01]、留置导尿时间短[WMD=-20.96,95% CI (-28.78,-13.15),P<0.01]、住院时间短[WMD=-22.87,95% CI (-36.48,-9.26),P=0.001]、围术期血红蛋白下降少[WMD=-0.24,95% CI (-0.36,-0.12),P<0.01]、输血少[RR=0.17,95% CI (0.04,0.73),P=0.02]、术后12个月的最大尿流率(Q_max)高[WMD=0.80,95% CI (0.12,1.48),P=0.02];而两组在切除组织重量、尿道狭窄、压力性尿失禁,术后1、6个月的Q_max,术后1、6、12个月的国际前列腺症状评分(IPSS)、生活质量评分(QOL)及残余尿量(PVR)方面差异均无统计学意义(P>0.05)。结论:HoLEP组术后12个月的Q_max较TURP组高,余随访期内Q_max、QOL、IPSS及PVR与TURP组相似。在留置导尿时间、住院时间及围手术期血红蛋白下降、输血率方面优于TURP组,而TURP组手术时间较HoLEP组存在优势。
- 钬激光剜除术 /
- 经尿道前列腺切除术 /
- 荟萃分析 /
- 良性前列腺增生
Abstract: Objective: To compare the efficacy and safety between holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP) in benign prostatic hyperplasia (BPH).Method: Several databases including Pubmed, Embase, Cochrane Library and Wanfang were searched to collect the clinical randomized controlled trials (RCTs) of HoLEP versus TURP in the treatment of BPH.The database was updated till May 2017.The results were assessed by mean difference, relative risk and corresponding 95%confidence interval (CI).The risk of bias of selected clinical trials was evaluated by the Cochrane Handbook.Result: Nine RCTs involving 1 145 patients were included.There were 575 cases in HoLEP group and 570 cases in TURP group.Compared with TURP group, HoLEP group had longer operation time[WMD=22.82, 95%CI (14.04, 31.59), P<0.01], shorter catheter time[WMD=-20.96, 95%CI (-28.78, -13.15), P<0.01], shorter hospitalization time[WMD=-22.87, 95%CI (-36.48, -9.26), P=0.001], less hemoglobin decrease[WMD=-0.24, 95%CI (-0.36, -0.12), P<0.01], less blood transfusion[RR=0.17, 95%CI (0.04, 0.73), P=0.02], higher maximum urinary flow rate (Q_max) at 12 months[WMD=0.80, 95%CI (0.12, 1.48), P=0.02], while there was no significant difference between the two groups in the weight of resected tissue, urethral stricture, urinary incontinence, Q_max at 1, 6 months, International Prostate Symptom Score (IPSS), quality of life (QOL) score or post-void residual volume (PVR) at 1, 6, 12 months (P>0.05).Conclusion: The Q_max of the HoLEP group was higher than that of TURP at 12 months postoperatively, but Q_max, QOL, IPSS and PVR were similar to those of the TURP group during other follow-up time.The HoLEP group has shorter catheter time and hospitalization time, less hemoglobin decline and blood transfusion rate than TURP group does.However, TURP group has an advantage in operation time.
- holmium laser enucleation /
- transurethral resection of the prostate /
- meta-analysis /
- benign prostatic hyperplasia

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