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首页> 外文期刊>BJU international >Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia.
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Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia.

机译：前摄单中心比较前列腺的120 W二极管泵浦固态高强度系统激光汽化和前列腺200 W高强度二极管激光消融治疗良性前列腺增生。

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OBJECTIVE: To evaluate the safety, efficacy and short-term outcome of a new 980 nm high-intensity diode (HiDi) laser (Limmer Laser, Berlin, Germany) system in comparison to the diode-pumped solid-state laser high-performance system (HPS; GreenLight(TM), AMS, Minnetonka, MI, USA) for treating benign prostatic hyperplasia (BPH) in a prospective non-randomized single-centre study. PATIENTS AND METHODS: From February to September 2007, 117 consecutive patients with lower urinary tract symptoms secondary to BPH were included; 62 patients were treated with 120-W HPS laser vaporization and 55 with 980-nm HiDi laser ablation of the prostate. We evaluated perioperative variables, and complications during and after surgery. Patients presenting for follow-up completed the International Prostate Symptom Score, and had their maximum urinary flow rate and postvoid residual urine volume measured. RESULTS: The mean (sd) age of the patients was 72.3 (8.8) years (HiDi) and 73.1 (10.8) years (HPS), with a mean preoperative prostate volume of 64.7 (29.7) and 67.4 (46.9) mL, respectively. The mean operative duration was comparable, at 56.4 (20.2) and 62.7 (36.3) min, respectively, whereas the mean energy delivery was significantly higher with the diode laser, at 313 (132) vs 187 (129) kJ (P < 0.001). For patients treated with the HPS the rate of visual impairment from bleeding was higher (0% vs 12.9%, P < 0.01), as was prostate capsule perforation (0% vs 4.8%, P > 0.05). Soon after surgery the rate of dysuria (23.6% vs 17.7%, P > 0.05) and transient urge incontinence (7.3% vs 0%; P < 0.05) was higher for the HiDi laser. During the follow-up there were higher rates of bladder neck stricture (14.5% vs 1.6%, P < 0.01), re-treatment (18.2% vs 1.6%, P < 0.01) and stress urinary incontinence (9.1% vs 0%; P < 0.05) for the HiDi laser group. CONCLUSION: Both systems investigated provide good tissue ablative properties. The HiDi laser at 980 nm is more favourable in terms of haemostasis. The penetration depths, resulting in coagulation necrosis and leading to increased re-treatment, bladder neck stricture and incontinence rates, were higher with the HiDi laser.
机译：目的：与二极管泵浦固态激光器高性能系统相比，评估新型980 nm高强度二极管（HiDi）激光器（Limmer Laser，柏林，德国）的安全性，有效性和短期结果（HPS; GreenLight（TM），AMS，Minnetonka，MI，美国）在一项前瞻性非随机单中心研究中用于治疗良性前列腺增生（BPH）。病人和方法：自2007年2月至2007年9月，连续117例BPH继发的下尿路症状患者被纳入研究。 62例患者接受120 W HPS激光汽化治疗，55例接受980 nm HiDi激光前列腺消融治疗。我们评估了围手术期的变量，以及手术期间和术后的并发症。进行随访的患者完成了国际前列腺症状评分，并测量了其最大尿流率和术后无尿残留量。结果：患者的平均（sd）年龄为72.3（8.8）岁（HiDi）和73.1（10.8）年（HPS），术前前列腺平均体积分别为64.7（29.7）和67.4（46.9）mL。平均手术持续时间相当，分别为56.4（20.2）和62.7（36.3）min，而二极管激光器的平均能量输送明显更高，分别为313（132）和187（129）kJ（P <0.001） 。对于接受HPS治疗的患者，因出血引起的视力障碍发生率更高（0％比12.9％，P <0.01），前列腺囊穿孔也一样（0％比4.8％，P> 0.05）。手术后不久，HiDi激光的排尿困难（23.6％vs. 17.7％，P> 0.05）和短暂性尿失禁的比率（7.3％vs 0％; P <0.05）更高。在随访期间，膀胱颈狭窄发生率较高（14.5％vs 1.6％，P <0.01），再治疗（18.2％vs 1.6％，P <0.01）和压力性尿失禁（9.1％vs 0％）; P <0.05）。结论：所研究的两种系统均具有良好的组织消融特性。就止血而言，980 nm的HiDi激光更为有利。 HiDi激光的穿透深度更高，导致凝结坏死并导致增加的再治疗，膀胱颈狭窄和失禁率。

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