绿激光直出式剜除和选择性汽化治疗良性前列腺增生症患者的随机对照研究

刘正超; 蒋涛; 陈志朋; 周远秀; 王永权; 周晓洲; 严滴石; 周占松; 沈文浩

doi:10.16016/j.1000-5404.201911198

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绿激光直出式剜除和选择性汽化治疗良性前列腺增生症患者的随机对照研究

临床医学 | 更新时间：2026-01-09

- 绿激光直出式剜除和选择性汽化治疗良性前列腺增生症患者的随机对照研究
- Green light top-firing sharp enucleation of prostate versus photoselective vaporisation of prostate for benign prostatic hyperplasia: a randomized controlled trial
- 第三军医大学学报 2020年42卷第5期页码：511-516
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院泌尿外科
- 作者简介：
  
  [沈文浩，E-mail:chongqingswh@aliyun.comSHEN Wenhao, E-mail: chongqingswh@aliyun.com
- 基金信息：
  
  陆军军医大学第一附属医院重大领域技术创新计划项目(SWH2016ZDCX2008);重庆市技术创新与应用示范(社会民生类)一般项目(CSTC2018jscx-msyb0682)
- DOI：10.16016/j.1000-5404.201911198
  中图分类号： R181.32;R697.32;R699.8
- 收稿：2019-11-24，
  
  修回：2019-12-27，
  
  纸质出版：2020-03-15
- 稿件说明：
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刘正超, 蒋涛, 陈志朋, 等. 绿激光直出式剜除和选择性汽化治疗良性前列腺增生症患者的随机对照研究[J]. 第三军医大学学报, 2020,42(5):511-516.

Zhengchao LIU, Tao JIANG, Zhipeng CHEN, et al. Green light top-firing sharp enucleation of prostate versus photoselective vaporisation of prostate for benign prostatic hyperplasia: a randomized controlled trial[J]. Journal of Third Military Medical University, 2020, 42(5): 511-516.
刘正超, 蒋涛, 陈志朋, 等. 绿激光直出式剜除和选择性汽化治疗良性前列腺增生症患者的随机对照研究[J]. 第三军医大学学报, 2020,42(5):511-516. DOI： 10.16016/j.1000-5404.201911198.

Zhengchao LIU, Tao JIANG, Zhipeng CHEN, et al. Green light top-firing sharp enucleation of prostate versus photoselective vaporisation of prostate for benign prostatic hyperplasia: a randomized controlled trial[J]. Journal of Third Military Medical University, 2020, 42(5): 511-516. DOI： 10.16016/j.1000-5404.201911198.

摘要

目的

对比经尿道直出光纤绿激光前列腺锐性剜除术(green light top-firing

sharp enucleation of the prostate

GTSEP)和绿激光选择性光汽化术(photoselective vaporisation of the prostate

PVP)治疗良性前列腺增生症(benign prostatic hyperplasia

BPH)患者的有效性和安全性。

方法

选取2018年6月至2019年4月在本院诊治的154例BPH患者，按随机数字表法分为两组，每组77例，分别行GTSEP和PVP。评估两组患者术前一般情况，记录并比较术后第1个月和第6个月国际前列腺症状评分(IPSS)、生活质量评分(QoLs)、残余尿(PVR)、最大尿流率(Qmax)、前列腺体积(PV)、前列腺特异抗原(PSA)及并发症等。

结果

两组各有74例患者完成了随访。两组患者术前基本资料差异无统计学意义。术后1、6个月，两组患者下尿路症状均较术前明显改善，但IPSS、QoLs、PVR、Qmax、PSA差异无统计学意义。GTSEP组手术时间明显短于PVP组(41.0±16.4

50.1±18.1 min

=0.001)，术后6个月GTSEP组前列腺体积小于PVP组(22.4±2.4

23.3±1.9 mL

=0.011)。两组术中和术后近期并发症差异无统计学意义。

结论

GTSEP与PVP治疗BPH均能获得较好的效果，GTSEP能更大程度去除增生的腺体组织，手术效率优于PVP。

Abstract

Objective

To compare the efficacy and safety of a novel procedure

green light top-firing

sharp enucleation of the prostate (GTSEP) and the traditional procedure

photoselective vaporisation of the prostate (PVP) in the treatment of benign prostatic hyperplasia (BPH).

Methods

A total of 154 patients diagnosed with BPH admitted in our hospital from June 2018 to April 2019 were recruited in this study

and then randomly divided into GTSEP group (

=77) and PVP group (

=77). All patients were assessed preoperatively an

d followed at 1 and 6 month postoperatively. International prostate symptom score (IPSS)

quality of life score (QoLs)

post-void residual urine (PVR)

maximum urine flow rate (Qmax)

prostate volume (PV)

prostate-specific antigen (PSA) and complications were recorded and compared between the 2 groups.

Results

There were 74 patients in each group completing the follow-up. No significant differences were found in baseline data between the 2 groups. At 1 and 6 months after surgery

both groups had their lower urinary tract symptoms significantly improved

but there were no significant differences in IPSS

QoLs

PVR

Qmax and PSA between the 2 groups. However

the GTSEP group had significantly shorter operation time (41.0±16.4

50.1±18.1 min

=0.001)

and smaller prostate volume at 6 months after surgery (22.4±2.4

23.3±1.9 mL

=0.011) when compared with the PVP group. No notable differences were seen in the incidence of intraoperative and postoperative complications between the 2 groups.

Conclusion

Both GTSEP and PVP achieve good efficacy and safety in BPH treatment. GTSEP can remove larger hyperplastic tissue than PVP

and is superior to PVP in operation efficacy.

关键词

Keywords

references

LUKACS B, CORNU J N, AOUT M, et al . Management of lower urinary tract symptoms related to benign prostatic hyperplasia in real-life practice in france: a comprehensive population study[J ] . Eur Urol, 2013, 64(3): 493-501. DOI:10.1016/j.eururo.2013.02.026.

KIM T H, HAN D H, RYU D S, et al . The impact of lower urinary tract symptoms on quality of life, work productivity, depressive symptoms, and sexuality in Korean men aged 40 years and older: A population-based survey[J ] . Int Neurourol J, 2015, 19(2): 120-129. DOI:10.5213/inj.2015.19.2.120.

THOMAS J A, TUBARO A, BARBER N, et al . A multicenter randomized noninferiority trial comparing GreenLight-XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two-yr outcomes of the GOLIATH study[J ] . Eur Urol, 2016, 69(1): 94-102. DOI:10.1016/j.eururo.2015.07.054.

AL-RAWASHDAH S F, PASTORE A L, SALHI Y A, et al . Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36-month outcomes[J ] . World J Urol, 2017, 35(10): 1595-1601. DOI:10.1007/s00345-017-2023-7.

CORNU J N, AHYAI S, BACHMANN A, et al . A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update[J ] . Eur Urol, 2015, 67(6): 1066-1096. DOI:10.1016/j.eururo.2014.06.017.

NASPRO R, GOMEZ SANCHA F, MANICA M, et al . From "gold standard" resection to reproducible "future standard" endoscopic enucleation of the prostate: what we know about anatomical enucleation[J ] . Italian J Urol Nephrol, 2017, 69(5): 446-458. DOI:10.23736/S0393-2249.17.02834-X.

EKEN A, SOYUPAK B. Safety and efficacy of photoselective vaporization of the prostate using the 180-W GreenLight XPS laser system in patients taking oral anticoagulants[J]. J Int Med Res, 2018, 46(3): 1230-1237. DOI:10.1177/0300060517747489.

LAI S C, PENG P X, DIAO T X, et al . Comparison of photoselective green light laser vaporisation versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta-analysis of randomised controlled trials and prospective studies[J ] . BMJ Open, 2019, 9(8): e028855. DOI:10.1136/bmjopen-2018-028855.

VALDIVIESO R, HUEBER P A, MESKAWI M, et al . Multicentre international experience of 532-nm laser photoselective vaporization with GreenLight XPS in men with very large prostates[J ] . BJU Int, 2018, 122(5): 873-878. DOI:10.1111/bju.14208.

ZHONG J, FENG Z H, PENG Y P, et al . A systematic review and meta-analysis of efficacy and safety following holmium laser enucleation of prostate and transurethral resection of prostate for benign prostatic hyperplasia[J ] . Urology, 2019, 131: 14-20. DOI:10.1016/j.urology.2019.03.034.

MISRAI V, KEREVER S, PHE V, et al . Direct comparison of GreenLight laser XPS photoselective prostate vaporization and GreenLight laser en bloc enucleation of the prostate in enlarged glands Greater than 80 ml: a study of 120 patients[J ] . J Urol, 2016, 195(4 Pt 1): 1027-1032. DOI:10.1016/j.juro.2015.10.080.

ELSHAL A M, ELKOUSHY M A, EL-NAHAS A R, et al . GreenLight TM laser (XPS) photoselective vapo-enucleation versus holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic hyperplasia: a randomized controlled study[J ] . J Urol, 2015, 193(3): 927-934. DOI:10.1016/j.juro.2014.09.097..

PANTHIER F, PASQUIER J, BRUEL S, et al . En bloc greenlight laser enucleation of prostate (GreenLEP): about the first hundred cases[J ] . World J Urol, 2019.[Epub ahead of print ] . DOI:10.1007/s00345-019-02941-1.

HERMANNS T, GROSSMANN N C, WETTSTEIN M S, et al . Is loss of power output due to laser fiber degradation still an issue during prostate vaporization using the 180 W GreenLight XPS laser?[J ] . World JUrol, 2019, 37(1): 181-187. DOI:10.1007/s00345-018-2377-5.

MISRAÏ V, PASQUIE M, BORDIER B, et al . Comparison between open simple prostatectomy and green laser enucleation of the prostate for treating large benign prostatic hyperplasia: a single-centre experience[J ] . World J Urol, 2018, 36(5): 793-799. DOI:10.1007/s00345-018-2192-z.

ENDO F, SHIGA Y, MINAGAWA S, et al . Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence[J ] . Urology, 2010, 76(6): 1451-1455. DOI:10.1016/j.urology.2010.03.071.

TAO H, JIANG Y Y, JUN Q, et al . Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate[J ] . Int Braz J Urol, 2016, 42(2): 302-311. DOI:10.1590/S1677-5538.IBJU.2014.0500.

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