Holmium laser enucleation versus simple prostatectomy for treating large prostates: Results of a systematic review and meta-analysis
| Autor: | Bhavan Prasad Rai, Laith Alzweri, Omar M. Aboumarzouk, Chris Bates, Bhaskar K. Somani, Patrick Jones |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment LASP laparoscopic simple prostatectomy Enucleation 030232 urology & nephrology Holmium laser WMD weighted mean difference chemistry.chemical_element Qmax maximum urinary flow rate law.invention Holmium 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Prostate law medicine RASP robot-assisted simple prostatectomy RCT randomised controlled trial HoLEP Prostatectomy MeSH Medical Subject heading business.industry Lasers PVR post-void residual urine volume OP open prostatectomy QoL quality of life Surgery medicine.anatomical_structure chemistry HoLEP holmium enucleation of the prostate BPH 030220 oncology & carcinogenesis Meta-analysis Prostatic Disorders Review business Open Prostatectomy |
| Zdroj: | Arab Journal of Urology |
| ISSN: | 2090-598X |
| DOI: | 10.1016/j.aju.2015.10.001 |
| Popis: | Objective To compare and evaluate the safety and efficacy of holmium laser enucleation of the prostate (HoLEP) and simple prostatectomy for large prostate burdens, as discussion and debate continue about the optimal surgical intervention for this common pathology. Materials and methods A systematic search was conducted for studies comparing HoLEP with simple prostatectomy [open (OP), robot-assisted, laparoscopic] using a sensitive strategy and in accordance with Cochrane collaboration guidelines. Primary parameters of interest were objective measurements including maximum urinary flow rate (Qmax) and post-void residual urine volume (PVR), and subjective outcomes including International Prostate Symptom Score (IPSS) and quality of life (QoL). Secondary outcomes of interest included volume of tissue retrieved, catheterisation time, hospital stay, blood loss and serum sodium decrease. Data on baseline characteristics and complications were also collected. Where possible, comparable data were combined and meta-analysis was conducted. Results In all, 310 articles were identified and after screening abstracts (114) and full manuscripts (14), three randomised studies (263 patients) were included, which met our pre-defined inclusion criteria. All these compared HoLEP with OP. The mean transrectal ultrasonography (TRUS) volume was 113.9 mL in the HoLEP group and 119.4 mL in the OP group. There was no statistically significant difference in Qmax, PVR, IPSS and QoL at 12 and 24 months between the two interventions. OP was associated with a significantly shorter operative time (P = 0.01) and greater tissue retrieved (P |
| Databáze: | OpenAIRE |
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