选择性绿激光前列腺汽化术与绿激光前列腺剜除术治疗良性前列腺增生的疗效对比

Photoselective vaporization of the prostate versus green laser enucleation of the prostate for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a single-center retrospective analysis

目的:比较选择性绿激光前列腺汽化术(PVP)与绿激光前列腺剜除术(GreenLEP)治疗良性前列腺增生(BPH)的疗效。方法:回顾性分析2019年6月至2020年12月浙江省人民医院泌尿外科因BPH导致下尿路症状而行手术的患者274例,根据手术方式不同,分为PVP组134例和GreenLEP组140例,比较两组患者围手术期和随访指标。结果:两组患者均顺利完成手术,术中无前列腺包膜穿孔、尿道括约肌损伤、大出血等并发症发生。与PVP组相比,GreenLEP组手术时间[(26.79±7.71)min vs.(48.21±19.38)min]、留置导尿管时间[(3.45±0.83)d vs.(3.71±1.23)d]、膀胱冲洗时间[(1.07±0.28)d vs.(1.28±0.47)d]较PVP组短,且GreenLEP组白细胞计数[(7.16±2.27)×109/L vs.(8.01±2.11)×109/L]更少。除此以外,相较于PVP组,GreenLEP组术后1月Qmax[(21.09±1.79)ml/s vs.(20.60±1.88)ml/s]更大,尿白细胞数值[24.45(4.9,21351.9)个/ul vs.35.50(5.7,32901.9)个/ul]和QOL评分[(1.29±0.53)分vs.(1.46±0.62)分]更小,差异均具有统计学意义(P<0.05)。结论:GreenLEP相比PVP不仅缩短了手术时间,还保留了组织标本,提高了患者的术后生活质量。

Objective:To compare the efficacy of photoselective vaporization of the prostate(PVP)and green laser enucleation of the prostate(GreenLEP)in the treatment of benign prostatic hyperplasia(BPH).Methods:From June 2019 to December 2020,274 patients with lower urinary tract symptoms caused by BPH in the Department of Urology of Zhejiang Provincial People’s Hospital were retrospectively analyzed.According to different surgical methods,the patients were divided into PVP group(n=134)and GreenLEP group(n=140).The perioperative and follow-up indexes of the two groups were compared.Results:Both groups of patients successfully completed the operation.No complications such as prostatic capsule perforation,urethral sphincter injury and massive hemorrhage occurred during the operation.Compared with PVP group,GreenLEP group had shorter operation time[(26.79±7.71)min vs.(48.21±19.38)min],indwelling catheter time[(3.45±0.83)d vs.(3.71±1.23)d]and the bladder flushing time[(1.07±0.28)d vs.(1.28±0.47)d].Besides,GreenLEP group had a less WBC count[(7.16±2.27)×109/L vs.(8.01±2.11)×109/L].In addition,Qmax of GreenLEP group at 1 month after surgery[(21.09±1.79)mL/s vs.(20.60±1.88)ml/s]was larger andurinary leukocyte count[24.45(4.9,21351.9)/μLvs.35.50(5.7,32901.9)/μL]and QOL score[(1.29±0.53)vs.(1.46±0.62)]were lower.The differences were statistically significant(P<0.05).Conclusion:Compared with PVP,GreenLEP can not only shorten the operation time,but also retain tissue samples and improve the quality of life of patients after operation.