激光汽化术与前列腺电切术治疗良性前列腺增生疗效的Meta分析

Diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia: a Meta-analysis

目的系统评价经尿道980nm激光汽化术与前列腺电切术(TURP)治疗良性前列腺增生(BPH)的疗效。方法收集国内外关于经尿道980nm激光汽化术与TURP治疗BPH的文献,采用Revman5.3软件进行Meta分析。结果筛选后共6篇文献符合纳入标准,总计839例,其中包括980nm激光治疗组450例和TURP组389例。Meta结果显示:和TURP组相比,980nm激光组手术时间差异无统计学意义[标准化均数差(SMD)=0.11,95%CI(-0.52,0.74),P>0.05],住院时间较短[SMD=-1.95,95%CI(-3.42,-0.48),P<0.05]及术后尿管留置时间较短[SMD=-2.64,95%CI(-3.92,-1.36),P<0.05]。980 nm激光组和TURP组在术后国际前列腺症状评分(IPSS)差异无统计学意义[加权均数差(WMD)=0.12,95%CI(-0.27,0.51),P>0.05],术后生活质量评分(QOL)评分差异无统计学意义[SMD=0.00,95%CI(-0.57,0.57),P>0.05],术后最大尿流率(Qmax)差异无统计学意义[SMD=0.06,95%CI(-0.26,0.37),P>0.05]。结论 980nm激光治疗良性BPH与经典的TURP术式相比,在住院时间和术后尿管留置时间方面有优势,远期效果无明显差异。

Objective To systematically review and evaluate the perioperative indicators and surgical curative effect of980nm diode laser vaporization of prostate and transurethral resesction of prostate(TURP)in treating benign prostatic hyperplasia(BPH).Methods Retrieved published comparative studies980nm diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia,and pooled the data from eligible studies.The statistical analysis was performed using Revman5.3software.Results Six trials including839patients were eligible to the criteria(450in980nm diode laser group and389in TURP group).The baseline of patients characteristics were comparable in all the studies.Meta analysis showed that:the operative time was not significantly different between the980nm diode laser group and TURP group[SMD=0.11,95~CI(-0.52,0.74),P>0.05];Compared with TURP group,980nm diode laser group has shorter hospital stays[SMD=-1.95,95%CI(-3.42,-0.48),P<0.05],and shorter catheterization time[SMD=-2.64,95%CI(-3.92,-1.36),P<0.05].There was no significant difference between IPSS[WMD=0.12,95%CI(-0.27,0.51),P>0.05],QOL[SMD=0.00,95%CI(-0.57,0.57),P>0.05]and Qmax[SMD=0.06,95%CI(-0.26,0.37),P>0.05].Conclusion980nm diode laser vaporization of prostate is safe and effective in treating benign prostatic hyperplasia,and compared with TURP,it has advantages in shorter hospital stays and shorter catheterization time.