经直肠超声引导下经会阴活检和经直肠活检前列腺癌检出率和并发症的比较:系统回顾和荟萃分析。

IF 1.7 3区 医学 Q4 ANDROLOGY
Translational andrology and urology Pub Date : 2025-05-30 Epub Date: 2025-05-27 DOI:10.21037/tau-2025-150
Jianhui Du, Shuang Chen, Martha K Terris, Hiroshi Miyamoto, Yanqin Yu, Qiao Ying
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引用次数: 0

摘要

背景:经直肠超声(TRUS)引导下的经会阴(TP)和经直肠(TR)入路已被用于系统性前列腺活检。荟萃分析比较TP和TR前列腺活检的癌症检出率(CDRs)和相关并发症。方法:检索PubMed、Web of Science、Embase、Cochrane Library、中国万方数据、中国知网(CNKI)自成立至2024年9月关于前列腺TP和TR活检的文献。结果:meta分析共纳入20项研究,分别纳入2979例和2610例接受TP和TR活检的患者。合并分析显示TP和TR活检的CDR无显著差异[相对危险度(RR) =0.98;95%置信区间(CI): 0.92-1.04;P = 0.46)。与TR入路相比,TP入路直肠出血风险较低(RR =0.05;95% ci: 0.02-0.13;结论:前列腺TP和TR活检具有相似的cdr。值得注意的是,与TR活检相比,TP活检涉及直肠出血、尿潴留和发烧的风险较低,但疼痛的风险较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of prostate cancer detection rates and complications between transrectal ultrasound-guided transperineal and transrectal biopsies: a systematic review and meta-analysis.

Background: Transrectal ultrasound (TRUS)-guided transperineal (TP) and transrectal (TR) approaches have been used for systematic prostate biopsy. A meta-analysis was conducted to compare the cancer detection rates (CDRs) and associated complications between TP and TR prostate biopsies.

Methods: PubMed, Web of Science, Embase, Cochrane Library, China Wanfang data, and China National Knowledge Infrastructure (CNKI) were searched for literature on TP and TR biopsies of the prostate from inception to September 2024.

Results: A total of 20 studies were included in the meta-analysis of 2,979 and 2,610 patients undergoing TP and TR biopsies, respectively. The pooled analysis indicated no significant difference in the CDR between the TP and TR biopsies [relative risk (RR) =0.98; 95% confidence interval (CI): 0.92-1.04; P=0.46]. Compared to the TR approach, the TP approach was associated with a lower risk of rectal bleeding (RR =0.05; 95% CI: 0.02-0.13; P<0.001), urinary retention (RR =0.70; 95% CI: 0.49-0.99; P=0.046), and fever (RR =0.24, 95% CI: 0.15-0.39; P<0.001). However, the risk of pain after the procedure was higher in the TP group (RR =2.04; 95% CI: 1.47-2.82; P<0.001). No significant difference was found in the risk of hematuria between the two groups (RR =1.05; 95% CI: 0.91-1.22; P=0.52).

Conclusions: TP and TR biopsies of the prostate have similar CDRs. Remarkably, compared to TR biopsy, TP biopsy involves a lower risk of rectal bleeding, urinary retention, and fever, but a higher risk of pain.

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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
80
期刊介绍: ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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