局部麻醉下徒手技术经会阴前列腺活检:系统回顾和荟萃分析

IF 1.6 Q3 UROLOGY & NEPHROLOGY
BJUI compass Pub Date : 2025-04-08 DOI:10.1002/bco2.70016
Benjamin M. Mac Curtain, Gavin Calpin, Josh Bruinsma, Wanyang Qian, Avinash Deshwal, Eoin Collins, Hugo C. Temperley, Reuben D. Mac Curtain, William P. Shields, Lee Chien Yap, Claudiu Cozman, John Keane, Padraig Daly
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引用次数: 0

摘要

背景局部麻醉下经会阴前列腺活检(TPPB)是一种广泛应用的活检方法,目前得到了欧洲泌尿外科协会(EAU)的认可。本综述旨在评估局部麻醉下TPPB对具有临床意义的前列腺癌的综合检出率。此外,还报告了疼痛评分和并发症。方法:我们的搜索是根据截至2024年8月的最新的系统评价和荟萃分析首选报告项目(PRISMA)建议进行的。该研究在PROSPERO上注册,ID: CRD42024588824。利用谷歌搜索引擎对PubMed、Embase和Cochrane Central Register of Controlled Trials数据库以及灰色文献进行了电子检索。结果共纳入2881例患者。11项研究包括2781例病例报告了活检组织学结果。我们观察到,在同时采用系统活检和靶向活检的研究中,具有临床意义的前列腺癌发病率为52% (95% CI 44%-60%),而在单独进行系统活检的研究中,前列腺癌发病率为26% (95% CI 23%-30%)。总的合并率为48% (95% CI为37%-59%)。9项研究共2688例患者报告了前列腺活检后的并发症。61例(2.3%)患者有Clavien-Dindo (CD) 1-2并发症,3例(0.1%)患者有CD 3-5并发症。cd1和cd2并发症的总发生率为2% (95% CI 1%-4%)。结论与其他方法相比,局部麻醉下TPPB是一种安全、有效、耐受性好的前列腺活检方法。在局部麻醉下进行手术似乎并不能降低癌症的检出率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Transperineal prostate biopsy with freehand technique under local anaesthetic: A systematic review and meta-analysis

Transperineal prostate biopsy with freehand technique under local anaesthetic: A systematic review and meta-analysis

Background

Transperineal prostate biopsy (TPPB) under local anaesthesia is a widely employed biopsy method, and is currently endorsed by the European Association of Urology (EAU). This review aimed to assess the pooled detection rates of clinically significant prostate cancer using TPPB under local anaesthetic. Additionally, pain scores and complications were also reported.

Methods

Our search was conducted in line with the most recent Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations up to August 2024. The study was registered on PROSPERO under the ID: CRD42024588824. An electronic search was conducted of the PubMed, Embase and Cochrane Central Register of Controlled Trials databases along with grey literature using the Google search engine.

Results

In total, there were 2881 patients included in this review. Biopsy histology results were reported in 11 studies comprising 2781 cases. We observed a clinically significant prostate cancer rate of 52% (95% CI 44%–60%) for studies that employed both a mix of systematic and targeted biopsies and 26% (95% CI 23%–30%) when systematic biopsies alone were taken. The pooled rate was 48% (95% CI 37%–59%), overall. Complications after prostate biopsies were reported by 9 studies with a combined 2688 patients. There were 61 patients (2.3%) who had Clavien–Dindo (CD) 1–2 complications and three patients (0.1%) who had CD 3–5 complications. The pooled rate of CD 1 and 2 complications was 2% (95% CI 1%–4%).

Conclusions

TPPB under local anaesthetic is a safe, efficacious and well-tolerated method of prostate biopsy when compared with other methods. Undertaking the procedure under local anaesthesia does not seem to lower cancer detection rates.

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CiteScore
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