首页良性前列腺增生治疗及预后证据详情

Endoscopic enucleation of the prostate (EEP). The same but different-a systematic review

原文:2021年 发布于 World J Urol 39卷 第7期 2383-2396 浏览量:809次 原文链接

作者: Pallauf M. Kunit T. Ramesmayer C. Deininger S. Herrmann T. R. W. Lusuardi L.

作者单位: Department of Urology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria. maximilian.pallauf@gmail.com. Department of Urology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria. Department of Urology, Spital Thurgau AG, Frauenfeld, Switzerland.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1007/s00345-021-03705-6

关键词: *Endoscopy Humans Male Prostatectomy Prostatic Hyperplasia BipolEP DiLEP Eep HoLEP Systematic review ThuLEP research collaboration travel grants honorarium.

文献简介

PURPOSE: Various techniques for EEP exist. They differ by surgical steps and the source of energy. It is assumed that the latter is of minor importance, whereas adherence to the anatomical enucleation template determines the postoperative result. So far, no systematic review highlights the differences between the energy sources in use for anatomical EEP. This study will address selfsame topic. METHODS: A systematic review of the literature was completed on September 1st, 2020. Studies comparing HoLEP, ThuLEP, DiLEP, or BipolEP with TUR-P providing 12 months of postoperative follow-up were included. Two frequentist network meta-analyses were created to compare the techniques of EEP indirectly. RESULTS: 31 studies, including 4466 patients, were found eligible for our meta-analysis. Indirect pairwise comparison showed differences in surgery time between BipolEP and HolEP (MD - 16.72 min., 95% CI - 27.75 to - 5.69) and DiLEP and HoLEP (MD - 22.41 min., 95% CI - 39.43 to - 5.39). No differences in the amount of resected prostatic tissue, major and minor complications and postoperative catheterization time were found. The odds for blood transfusions were threefold higher for BipolEP than for HoLEP (OR 3.27, 95% CI 1.02-10.5). The difference was not statistically significant when comparing prospective trials and matched-pair analysis only (OR 3.25, 95% CI 0.94-11.18). The Qmax 12 months after surgery was 2 ml/sec. higher for BipolEP than for DiLEP (MD  2.00, 95% CI 0.17-3.84) and 1.94 ml/sec. lower for DiLEP than for HoLEP (MD - 1.94, 95% CI - 3.65 to - 0.22). CONCLUSION: The energy source used for EEP has an impact on the intervention itself. BipolEP promotes surgical efficiency; laser techniques lower the risk of bleeding. REGISTRY: This meta-analysis is registered in the PROSPERO international prospective register registry with the registration number CRD42020205836.

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