首页良性前列腺增生治疗及预后证据详情

Holmium laser enucleation of the prostate in benign prostate hyperplasia patients with or without oral antithrombotic drugs: a meta-analysis

原文:2019年 发布于 Int Urol Nephrol 51卷 第12期 2127-2136 浏览量:754次 原文链接

作者: Zheng X. Peng L. Cao D. Han X. Xu H. Yang L. Ai J. Wei Q.

作者单位: West China Medical School, Sichuan University, Chengdu, Sichuan, People's Republic of China. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China. jianzhong.ai@scu.edu.cn. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China. weiqiang933@126.com.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1007/s11255-019-02278-z

关键词: Administration Oral Fibrinolytic Agents/*administration & dosage Humans Lasers Solid-State Male Prostatic Hyperplasia Risk Factors Antithrombotic Benign prostate hyperplasia (BPH) Holmium laser enucleation of the prostate (HoLEP) Perioperative safety

文献简介

BACKGROUND: The continuous intake of antithrombotic drugs during holmium laser enucleation of the prostate (HoLEP) remains nonconsensual. We aim to pool those controversial evidence and provide practical guidance of oral antithrombotics on HoLEP for benign prostate hyperplasia (BPH). METHOD: PubMed, Embase and CENTRAL database were systematically searched up to June 2019 for trials on patients with and without oral antithrombotics undergoing HoLEP. Number of events and mean value with standard deviation were, respectively, extracted for dichotomous and continuous parameters. Subgroup analyses of anticoagulation and antiplatelet were also performed. All statistical analyses were conducted with Review Manager v.5.3 software. Newcastle-Ottawa Scale (NOS) was used to assess the quality of selected trials. RESULT: Nine studies with 5528 patients were eventually selected, and patients included were generally older than 65 years. It revealed that the non-antithrombotic group had a lower rate of blood transfusion (OR 0.21, 95% CI 0.10-0.45, P < 0.0001), bladder tamponade (OR 0.30, 95% CI 0.13-0.69, P = 0.004) and acute urine retention (OR 0.52, 95% CI 0.30-0.89, P = 0.02). Operation time was also shorter (MD - 10.31, 95% CI - 12.76 to - 7.85, P < 0.00001) in the non-antithrombotic group, but the heterogeneity was considerable (I(2) = 75%). Subgroup analyses were generally consistent with the primary analysis except the non-anticoagulation and anticoagulation group having similar operation time (MD 6.66, 95% CI - 7.15 to 20.48, P = 0.34). CONCLUSION: The current study confirmed that continuous intake of antithrombotic drugs could significantly increase the risk of bleeding and blood transfusion, bladder tamponade and acute urine retention.

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