Perioperative outcomes of HoLEP, ThuLEP, and TURP in patients with prostate cancer: results from the GRAND study.

IF 5.8 2区 医学 Q1 ONCOLOGY
Nikolaos Pyrgidis, Gerald Bastian Schulz, Philipp Weinhold, Michael Atzler, Leo Federico Stadelmeier, Iason Papadopoulos, Christian Stief, Julian Marcon, Patrick Keller
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Abstract

Background: Limited data exist on the role of holmium laser enucleation of the prostate (HoLEP), thulium laser enucleation of the prostate (ThuLEP), and transurethral resection of the prostate (TURP) in patients with prostate cancer (PCa). We aimed to analyze their perioperative outcomes and trends.

Materials and methods: The German Nationwide Inpatient Data (GRAND) registry was used to identify male patients diagnosed with PCa who underwent HoLEP, ThuLEP, or TURP between 2005 and 2022. Multivariable regression analyses were performed to compare perioperative morbidity and mortality.

Results: A total of 221,768 procedures in patients with PCa were performed: 8160 HoLEP, 2285 ThuLEP, and 211,323 TURP. Although TURP remains the predominant technique, the use of HoLEP and ThuLEP has increased significantly in recent years, representing 17% of all cases by 2022. Perioperative outcomes were worse for TURP, with higher transfusion (8.8%) and ICU admission rates (1.7%) compared to HoLEP and ThuLEP (both 2.5% and ≤1.2%, respectively). Postoperative urinary retention and incontinence rates were also lower for laser enucleation techniques than TURP. In patients with PCa undergoing TURP, perioperative outcomes were worse compared to those without PCa, while outcomes for HoLEP and ThuLEP were comparable regardless of PCa status.

Conclusion: HoLEP and ThuLEP offer improved perioperative outcomes compared to TURP in patients with PCa.

前列腺癌患者HoLEP、ThuLEP和TURP围手术期预后:GRAND研究结果
背景:关于钬激光前列腺去核术(HoLEP)、铥激光前列腺去核术(ThuLEP)和经尿道前列腺切除术(TURP)在前列腺癌(PCa)患者中的作用的资料有限。我们的目的是分析他们的围手术期结局和趋势。材料和方法:使用德国全国住院患者数据(GRAND)登记来识别2005年至2022年间接受HoLEP、ThuLEP或TURP治疗的男性PCa患者。采用多变量回归分析比较围手术期发病率和死亡率。结果:共有221,768例PCa患者进行了手术:8160例HoLEP, 2285例ThuLEP和211,323例TURP。虽然TURP仍然是主要的技术,但近年来HoLEP和ThuLEP的使用显著增加,到2022年占所有病例的17%。与HoLEP和ThuLEP(分别为2.5%和≤1.2%)相比,TURP的围手术期结局更差,输血率(8.8%)和ICU入院率(1.7%)更高。激光去核术的术后尿潴留和尿失禁率也低于TURP。在接受TURP的PCa患者中,围手术期结果比未接受前列腺癌的患者差,而HoLEP和ThuLEP的结果与前列腺癌状态无关。结论:与TURP相比,HoLEP和ThuLEP可改善PCa患者的围手术期预后。
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来源期刊
Prostate Cancer and Prostatic Diseases
Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学
CiteScore
10.00
自引率
6.20%
发文量
142
审稿时长
6-12 weeks
期刊介绍: Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.
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