Nikolaos Pyrgidis, Gerald Bastian Schulz, Philipp Weinhold, Michael Atzler, Leo Federico Stadelmeier, Iason Papadopoulos, Christian Stief, Julian Marcon, Patrick Keller
{"title":"前列腺癌患者HoLEP、ThuLEP和TURP围手术期预后：GRAND研究结果","authors":"Nikolaos Pyrgidis, Gerald Bastian Schulz, Philipp Weinhold, Michael Atzler, Leo Federico Stadelmeier, Iason Papadopoulos, Christian Stief, Julian Marcon, Patrick Keller","doi":"10.1038/s41391-025-00980-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>HoLEP and ThuLEP offer improved perioperative outcomes compared to TURP in patients with PCa.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perioperative outcomes of HoLEP, ThuLEP, and TURP in patients with prostate cancer: results from the GRAND study.\",\"authors\":\"Nikolaos Pyrgidis, Gerald Bastian Schulz, Philipp Weinhold, Michael Atzler, Leo Federico Stadelmeier, Iason Papadopoulos, Christian Stief, Julian Marcon, Patrick Keller\",\"doi\":\"10.1038/s41391-025-00980-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>HoLEP and ThuLEP offer improved perioperative outcomes compared to TURP in patients with PCa.</p>\",\"PeriodicalId\":20727,\"journal\":{\"name\":\"Prostate Cancer and Prostatic Diseases\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.8000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Prostate Cancer and Prostatic Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1038/s41391-025-00980-x\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prostate Cancer and Prostatic Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41391-025-00980-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Perioperative outcomes of HoLEP, ThuLEP, and TURP in patients with prostate cancer: results from the GRAND study.
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.
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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