180W绿激光经尿道前列腺汽化切除术与汽化术早期疗效的对比研究

Comparison of the Early Efficacy between Greenlight 180W-XPS Vapor-Incision Technique(PVP-VIT)and Photo-selective Vaporization of the Prostate(PVP)in the Treatment of Benign Prostatic Hyperplasia

目的对比180W绿激光经尿道前列腺汽化切除术(PVP-VIT)与前列腺汽化术(PVP)治疗体积>60mL前列腺增生患者的早期临床疗效。方法统计2017年10月-2019年5月在本科采用180WXPS绿激光系统治疗体积>60mL前列腺增生患者,其中随机法选取PVP-VIT组和PVP组各50例。比较两组手术时间、手术失血量、术后膀胱冲洗时间、尿管留置时间,术中及术后并发症情况,记录随访两组患者手术前后国.际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)、残余尿(PVR)。结果所有手术均成功完成,无输血、直肠损伤、电切综合征(TURS)等并发症发生,两组患者一般资料,如年龄、前列腺大小、IPSS、QOL、Qmax及PVR等比较无统计学差异,VIT组手术时间(45.4±16.9)min少于PVP组手术时间(71.1±20.9)min,差异有统计学意义(P<0.05),前者手术失血量(9.3±6.6)mL明显少于后者(26.5±10.6)mL,差异有统计学意义(P<0.05)。两组患者术后膀胱冲洗时间及尿管留置时间无统计学差异(P>0.05),术中及术后并发症情况,两组比较无统计学差异(P>0.05)。两组患者术后6月IPSS、QOL、Qmax、PVR较术前均有明显好转,但两组比较差异无统计学意义(P>0.05)。结论与PVP相比,PVP-VIT治疗体积>60mL前列腺增生是安全有效的,术后6月两组手术效果相当,并在手术时间及失血量优势明显,但仍需要长期随访以准确评估疗效和再治疗率。

Objective To compare the early clinical efficacy between GreenLight 180W-XPS vapor-incision technique (PVP-VIT) and photo-selective vaporization of the prostate (PVP) in the treatment of benign prostatic hyperplasia with volume > 60mL.Methods Data were retrospectively collected for men with BPH treated with laser prostatectomy using Greenlight XPS-180W between October 2017 and May 2019.50 cases of PVP-VIT group and the same cases of the PVP group were randomly selected.The operation duration,hemorrhage volume,postoperative bladder irrigation time,catheterization time,intraoperative and postoperative complications were compared between them,and the international prostate symptoms score (IPSS),quality of life (QOL),maximum flow rate (Qmax) and post-void residual (PVR) were recorded pre and post the operation.Results All surgery was successfully completed,no complications such as blood transfusion,rectal injury,transurethral resection syndrome (TURS) occurred.There was no statistical difference in the general data of the two groups,such as age,course of disease and volume of the prostate.The operation time in the former (45.4±16.9 min) was shorter than the PVP group (71.1±20.9min) (P<0.05),and a significantly lower blood loss (9.3±6.6 mL) than the latter (26.5±10.6mL) (P<0.05),which was statistically significant.There was no significant difference in bladder irrigation time,the catheterization time,and complications between the two groups of patients (P>0.05),IPSS,QOL,Qmax and PVR were significantly improved in the two groups at 6 months after surgery,but the difference between the two groups was not statistically significant (P>0.05).Conclusions PVP-VIT is safe and efficacious,providing the equivalent improvements in functional outcomes at 6 months in comparison to PVP.Furthermore,it is associated with shorter operative time and less blood loss.Long-term follow-up is needed to accurately assess functional outcomes and retreatment rates.