{"title":"一项前瞻性、单中心、随机临床试验，评估三种激光汽化手术使用180w GreenLight XPS激光器、300w二极管激光器和200w铥激光器治疗良性前列腺增生的疗效","authors":"Tatsunori Okada, Mikifumi Koura, Ryota Sumikawa, Hiroyuki Masaoka, Yoohyun Song, Takashi Dejima, Narihito Seki","doi":"10.1111/luts.12453","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>This study aimed to compare the safety and efficacy of three different laser prostate vaporization surgeries, which were photoselective vaporization of the prostate (PVP), diode laser vaporization (DVP), and thulium laser vaporization (ThuVAP), for the treatment of benign prostatic hyperplasia (BPH) in a randomized clinical trial.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 71 consecutive patients with BPH were included; 23 patients were treated with PVP, 23 with DVP, and 25 with ThuVAP. Patients were evaluated with disease-related symptomatic questionnaires, Quality of Life (QOL) Index, and maximum urinary flow rate (<i>Q</i><sub>max</sub>) for 12 months. Patients were monitored to record operation/vaporization time, 24-hour hemoglobin/sodium drop, length of catheterization/hospitalization, and perioperative/postoperative complications.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In all three groups, patients showed significant and comparable improvements in symptom scores, QOL Index, and <i>Q</i><sub>max</sub> during the 12-month follow-up period. The mean operation/vaporization time was equivalent across all three groups at 69/23 (PVP), 81/34 (DVP), and 76/32 minutes (ThuVAP), while the applied laser energy was lower for PVP at 157 kJ compared to the other two techniques (DVP at 358 kJ, ThuVAP at 240 kJ). The mean vaporization rates per unit energy were significantly different between the three groups (PVP 0.16, DVP 0.09, and ThuVAP 0.09 mL/kJ). There were no significant differences in the main safety profiles between the three groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our study demonstrated that these three types of laser surgeries are similar in terms of complications and outcomes, with excellent hemostasis and high patient satisfaction. It was suggested that sufficient tissue vaporization could be achieved using less energy through PVP surgery.</p>\n </section>\n </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"A prospective, single-center, randomized clinical trial to evaluate the efficacy of three types of laser vaporization surgeries using a 180-W GreenLight XPS laser, a 300-W diode laser, and a 200-W thulium laser for the treatment of benign prostatic hyperplasia\",\"authors\":\"Tatsunori Okada, Mikifumi Koura, Ryota Sumikawa, Hiroyuki Masaoka, Yoohyun Song, Takashi Dejima, Narihito Seki\",\"doi\":\"10.1111/luts.12453\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>This study aimed to compare the safety and efficacy of three different laser prostate vaporization surgeries, which were photoselective vaporization of the prostate (PVP), diode laser vaporization (DVP), and thulium laser vaporization (ThuVAP), for the treatment of benign prostatic hyperplasia (BPH) in a randomized clinical trial.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A total of 71 consecutive patients with BPH were included; 23 patients were treated with PVP, 23 with DVP, and 25 with ThuVAP. Patients were evaluated with disease-related symptomatic questionnaires, Quality of Life (QOL) Index, and maximum urinary flow rate (<i>Q</i><sub>max</sub>) for 12 months. Patients were monitored to record operation/vaporization time, 24-hour hemoglobin/sodium drop, length of catheterization/hospitalization, and perioperative/postoperative complications.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In all three groups, patients showed significant and comparable improvements in symptom scores, QOL Index, and <i>Q</i><sub>max</sub> during the 12-month follow-up period. The mean operation/vaporization time was equivalent across all three groups at 69/23 (PVP), 81/34 (DVP), and 76/32 minutes (ThuVAP), while the applied laser energy was lower for PVP at 157 kJ compared to the other two techniques (DVP at 358 kJ, ThuVAP at 240 kJ). The mean vaporization rates per unit energy were significantly different between the three groups (PVP 0.16, DVP 0.09, and ThuVAP 0.09 mL/kJ). There were no significant differences in the main safety profiles between the three groups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Our study demonstrated that these three types of laser surgeries are similar in terms of complications and outcomes, with excellent hemostasis and high patient satisfaction. It was suggested that sufficient tissue vaporization could be achieved using less energy through PVP surgery.</p>\\n </section>\\n </div>\",\"PeriodicalId\":18028,\"journal\":{\"name\":\"LUTS: Lower Urinary Tract Symptoms\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2022-06-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"LUTS: Lower Urinary Tract Symptoms\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/luts.12453\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"LUTS: Lower Urinary Tract Symptoms","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/luts.12453","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
A prospective, single-center, randomized clinical trial to evaluate the efficacy of three types of laser vaporization surgeries using a 180-W GreenLight XPS laser, a 300-W diode laser, and a 200-W thulium laser for the treatment of benign prostatic hyperplasia
Objectives
This study aimed to compare the safety and efficacy of three different laser prostate vaporization surgeries, which were photoselective vaporization of the prostate (PVP), diode laser vaporization (DVP), and thulium laser vaporization (ThuVAP), for the treatment of benign prostatic hyperplasia (BPH) in a randomized clinical trial.
Methods
A total of 71 consecutive patients with BPH were included; 23 patients were treated with PVP, 23 with DVP, and 25 with ThuVAP. Patients were evaluated with disease-related symptomatic questionnaires, Quality of Life (QOL) Index, and maximum urinary flow rate (Qmax) for 12 months. Patients were monitored to record operation/vaporization time, 24-hour hemoglobin/sodium drop, length of catheterization/hospitalization, and perioperative/postoperative complications.
Results
In all three groups, patients showed significant and comparable improvements in symptom scores, QOL Index, and Qmax during the 12-month follow-up period. The mean operation/vaporization time was equivalent across all three groups at 69/23 (PVP), 81/34 (DVP), and 76/32 minutes (ThuVAP), while the applied laser energy was lower for PVP at 157 kJ compared to the other two techniques (DVP at 358 kJ, ThuVAP at 240 kJ). The mean vaporization rates per unit energy were significantly different between the three groups (PVP 0.16, DVP 0.09, and ThuVAP 0.09 mL/kJ). There were no significant differences in the main safety profiles between the three groups.
Conclusions
Our study demonstrated that these three types of laser surgeries are similar in terms of complications and outcomes, with excellent hemostasis and high patient satisfaction. It was suggested that sufficient tissue vaporization could be achieved using less energy through PVP surgery.
期刊介绍：
LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided.
LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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