经尿道钬激光前列腺剜除术与经尿道前列腺电切术治疗前列腺增生的Meta分析

Meta-analysis of transurethral holmium laser prostatectomy and transurethral resection of prostate in the treatment of benign prostatic hyperplasia

目的比较经尿道钬激光前列腺剜除术(HoLEP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的疗效和安全性。方法检索中国知网(CNKI)、万方医学网、PubMed、Elsevier ScienceDirect等数据库,收集HoLEP与TURP随机对照研究的临床文献,观察指标:手术时间、输血率、腺体切除量、留置尿管时间、住院时间、最大尿流率(Qmax)、残余尿(PVR)、国际前列腺症状评分(I-PSS)、尿道狭窄发生率等。结果经过筛选最后纳入9篇文献,中文4篇,英文5篇,共1080例患者。Meta分析结果 :HoLEP与TURP相比具有出血少、无需输血、术后留置尿管时间及住院时间短、术后残余尿少,但手术时间相对较长。结论 Meta分析示HoLEP与TURP相比,具有更安全、更可靠的优点,且能缩短导尿时间及住院时间,有望取代经尿道前列腺电切术成为新的"金标准"。

Objective To compare the efficacy and safety of transurethral holmium laser enamelectomy（HoLEP） and transurethral resection of prostate（TURP） in the treatment of benign prostatic hyperplasia （BPH）. Methods The databases including CNKI, Wanfang, PubMed, Elsevier ScienceDirect were researched to collect The clinical data of HoLEP and TURP randomized controlled study. The observation indexes included operation time, blood transfusion rate, glandular resection, indwelling catheterization time, hospitalization time, maximum urinary flow rate（Qmax）, residual urine （PVR）, international prostate symptom score （I-PSS） and the incidence of urethral stricture, etc.. Results Nine articles were in- cluded finally in the study after screening, including 4 cases in Chinese and 5 cases in, English. And there were 1080 patients totally. M.eta analysis results showed that HoLEP had less bleeding, no blood transfusion, shorter postoperative indwelling catheter time, shorter hospital stay, less postoperative residual urine, longer operation time compared with TURP. Conclusions Meta-analysis shows that HoLEP has a safer and more reliable advantage, and especially can shorter catheterization time and hospitalization time. It is expected to replace transurethral resection of prostate to be- come a new ＂gold standard＂.