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首页> 外文期刊>BJU international >Comparison of potassium-titanyl-phosphate laser vaporization of the prostate and transurethral resection of the prostate: update of a prospective non-randomized two-centre study.
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Comparison of potassium-titanyl-phosphate laser vaporization of the prostate and transurethral resection of the prostate: update of a prospective non-randomized two-centre study.

机译：前列腺素和钛的尿道切除术的磷酸钛氧钛磷酸酯激光汽化的比较：前瞻性非随机两中心研究的更新。

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OBJECTIVES: To evaluate the intermediate-term clinical efficacy and the rate of complications in 80 W photoselective vaporization of the prostate (PVP) with the potassium-titanyl-phosphate laser (Greenlight, (AMS, Minnetonka, MN, USA) compared with transurethral resection of the prostate (TURP) in a prospective non-randomised two-centre study. PATIENTS AND METHODS: From December 2003 to August 2006, 396 patients (PVP 269, TURP 127) with lower urinary tract symptoms secondary to benign prostatic hyperplasia were included in the study. There was a significant difference in mean age (72 years for PVP vs 68 for TURP, P = 0.001). Patients were therefore stratified in age categories (<70, 70-80, >80 years) and compared for perioperative variables, functional outcome and complications, with a follow-up of up to 24 months. RESULTS: The mean prostate size was greater (overall, 62 vs 48 mL, P < 0.001) and mean operative duration longer (overall 72 vs 53 min; P = 0.001) for PVP in all age categories. The rate of intraoperative bleeding (3% vs 11%), blood transfusions (0% vs 5.5%) and capsule perforations (0.4% vs 6.3%), and early postoperative clot retention (0.4% vs 3.9%) was significantly lower for PVP. Hospitalization time was significantly shorter in the PVP group for patients aged <70 years (3.0 vs 4.7 days) and 70-80 years (4.0 vs 5.0 days; P = 0.001). The improvement of peak urinary flow rate was higher after TURP for any age category. The International Prostate Symptom Score and postvoid residual volume during the follow-up showed no significant difference. After 12 months the overall prostate size reduction was 63% (-30 mL) after TURP and 44% (-27 mL) after PVP. The rate of repeat TURP/PVP was higher in the PVP group (6.7% vs 3.9%, not significant) within the follow-up of up to 2 years. The incidence of urethral and bladder neck strictures was comparable. CONCLUSIONS: PVP was more favourable in terms of perioperative safety. Although patients assigned for PVP were older and had larger prostates, PVP resultedin a similar functional outcome. Further follow-up is needed to draw final conclusions about the long-term efficacy of PVP.
机译：目的：评估经钛酸钾-磷酸钾激光（Greenlight，（AMS，Minnetonka，MN，美国））与经尿道切除术比较的80 W前列腺光选择性汽化（PVP）的中期临床疗效和并发症发生率患者和方法：2003年12月至2006年8月，纳入396例因良性前列腺增生引起的下尿路症状的患者（PVP 269，TURP 127）。平均年龄存在显着差异（PVP为72岁，TURP为68岁，P = 0.001），因此将患者按年龄类别（<70、70-80，> 80岁）进行了分层，并比较了围手术期变量，功能预后和并发症，最多随访24个月结果：平均前列腺大小更大（总体为62 vs 48 mL，P <0.001），平均手术时间更长（总体为72 vs 53 min; P = 0.001），适用于所有年龄段的PVP ies。 PVP的术中出血（3％vs 11％），输血（0％vs 5.5％）和包膜穿孔（0.4％vs 6.3％）以及术后早期凝块保留率（0.4％vs 3.9％）的发生率显着降低。 PVP组中<70岁（3.0 vs 4.7天）和70-80岁（4.0 vs 5.0天; P = 0.001）的患者的住院时间明显缩短。 TURP后，任何年龄段的患者峰值尿流率的改善都更高。随访期间的国际前列腺症状评分和术后无残留量均无显着差异。 12个月后，TURP后总体前列腺体积缩小为63％（-30 mL），PVP后为44％（-27 mL）。在长达2年的随访中，PVP组的TURP / PVP重复率较高（6.7％比3.9％，不显着）。尿道和膀胱颈狭窄的发生率具有可比性。结论：就围手术期安全性而言，PVP更有利。尽管分配PVP的患者年龄较大且前列腺较大，但PVP的功能预后相似。需要进一步的随访以得出有关PVP长期疗效的最终结论。

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