Long-term clinical outcomes of anatomic GreenLight laser vaporization-incision technique for the treatment of benign prostatic hyperplasia
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摘要: 目的 评估绿激光解剖性汽化切除术治疗前列腺增生(benign prostatic hyperplasia，BPH)的远期疗效。方法 收集2019年1月—2020年3月在苏州大学附属第二医院接受绿激光解剖性汽化切除术治疗的133例BPH患者的临床资料，对患者进行为期3年的术后随访，收集前列腺体积(prostate volume，PV)、最大尿流率(maximum flow rate，Qmax)、国际前列腺症状评分(International Prostate Symptoms Score，IPSS)、生活质量(Quality of Life，QoL)评分、前列腺特异性抗原(prostate-specific antigen，PSA)、膀胱残余尿(postvoid residual，PVR)等指标及术后并发症发生情况。结果 所有患者手术均顺利完成，术后IPSS评分、QoL评分、Qmax、PVR等指标明显好转，术后3个月复查PV降低59.2%。在3年随访中，患者各项指标均保持稳定，无一例患者因BPH再次手术。术后短期并发症发生率依次为尿路刺激征(27.1%)、血尿(11.3%)、尿潴留(3.0%)等，远期并发症统计结果中有1例患者术后发生尿道狭窄。结论 绿激光解剖性汽化切除术治疗BPH安全、有效，值得临床推广。Abstract: Objective To evaluate the long-term clinical outcomes of anatomic GreenLight laser vaporization-incision technique for the treatment of benign prostatic hyperplasia (BPH)Methods From January 2019 to March 2020, 133 BPH patients who received anatomic GreenLight laser vaporization-incision technique at Second Affiliated Hospital of Soochow University were included in the present study. Three-year patient-reported clinical data and clinical characteristics after the operation were collected, including International Prostate Symptoms Score (IPSS), prostate volume(PV), maximum flow rate (Qmax), prostate-specific antigen (PSA), postvoid residual (PVR), operative complication, etc.Results All operations were successfully performed. IPSS score, QoL score, PVR and Qmax improved significantly after the operation. PV decreased about 59.2% three months after the operation. During the long-term follow-up for 3 years, the clinical characteristics didn't change significantly and no patients received reoperation. The incidences of short-term postoperative complications were urinary tract irritation (27.1%), hematuria (11.3%), urinary retention (3.0%), etc. Only one patient experienced long-term complication of postoperative urethral stricture.Conclusion Anatomic GreenLight laser vaporization-incision technique is safe and effective in the treatment of BPH for long-term follow-up, which is worthy of clinical promotion.
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表 1 患者术前、术后指标变化
X±S，M(P25，P75) 指标 术前 术后1个月 术后3个月 术后1年 术后3年 PV/mL 72.3±16.5 29.5±5.81) 33.2±3.71) 36.9±5.51) PSA/(ng/mL) 3.6±2.7 1.3±1.11) 1.4±1.21) 1.8±1.42) IPSS/分 22.5±4.2 11.6±3.61) 9.2±3.31) 6.5±2.91) 7.9±4.71) QoL/分 4.3±0.6 2.1±0.52) 1.8±0.61) 1.6±0.51) 1.9±0.41) Qmax/(mL/s) 7.3±2.6 20.9±10.21) 21.5±9.61) 20.5±9.31) 19.4±8.51) PVR/mL 82.2(36.5，135.6) 25.6(10.5，38.3)1) 20.1(8.5，28.3)1) 29.5(15.7，36.8)1) 46.5(13.6，61.4)1) 与术前比较，1)P < 0.001，2)P < 0.01。 
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