首页良性前列腺增生治疗及预后证据详情

Photoselective vaporization has comparative efficacy and safety among high-risk benign prostate hyperplasia patients on or off systematic anticoagulation: a meta-analysis

原文:2019年 发布于 World Journal of Urology 37卷 第7期 1377-1387 浏览量:1183次 原文链接
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PurposeThe necessity to cease anticoagulation before photoselective vaporization (PVP) surgery remains nonconsensual. We aimed at assessing the efficacy and safety of PVP among high-risk benign prostate hyperplasia (BPH) patients on or off anticoagulation.MethodsWe systematically searched Pubmed, Embase, and Cochrane Library Central Register of Controlled Trials (CENTRAL). 2299 patients from 11 studies were eventually included. Newcastle-Ottawa Scale (NOS) was employed to assess the quality and risk of bias of each study. All statistical analyses were conducted with Review Manager v.5.3 software.ResultsTen parameters (operation time, laser time, blood transfusion, urethral stricture, urinary tract infection, reoperation, dysuria, capsule perforation, catheterization time, and re-catheterization) from patients on or off anticoagulant therapy were collected. The patients without anticoagulants performed better at catheterization time [MD -0.54, 95% CI (-0.82, -0.26), P=0.96, I-2=0] with a reduction of 0.54day than those on anticoagulants. Significant statistical difference was not observed from other parameters. Subgroup analysis, grouped by the power output of PVP systems (80W, 120W and 180W), consistently showed no statistical significant difference except at catheterization time in the 180-W PVP subgroup.ConclusionPVP, a safe and effective option for high-risk BPH patients, work comparably regardless of anticoagulant therapy, despite non-anticoagulant patients have shorter catheterization time. It is implied that the use of anticoagulants might be unnecessary to stop for high-risk BPH patients undergoing PVP for the sake of safety, which certainly requires further investigations to confirm.

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