Efficacies and safety of holmium and thulium laser enucleation in treatment of benign prostatic hyperplasia: a meta-analysis

doi:10.3760/cma.j.cn441417-20240731-06011

Abstract

Abstract:

Objective　To explore the effects and safety of holmium laser enucleation (HoLEP) versus thulium laser enucleation (ThULEP) for benign prostatic hyperplasia. Methods　The PubMed, EMbase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database were searched for the clinical studies on HoLEP and ThULEP for benign prostatic hyperplasia from their establishment to April 2024. The methodological quality of the included literature was evaluated by the Cochrane Risk of Bias Assessment Tool, and the included data were statistically analyzed by the RevMan 5.4.1 software. Results　A total of 11 articles were included in this study, involving 2 029 patients with benign prostatic hyperplasia. The meta-analysis results showed that there were no statistical differences in the post-void residual urine (PVR), international prostate symptom score (IPSS), score of quality of life (QOL), urinary maximum flow rate (Qmax), prostate-specific antigen (PSA), incidence rate of complications, operation time, enucleation time, and extubation time between the patients with benign prostatic hyperplasia taking HoLEP and ThULEP (all P>0.05). The enucleation time of the patients taking HoLEP was longer than that of the patients taking ThULEP (P<0.05); the intraoperative bleeding volume in the patients taking HoLEP was higher than that in the patients taking ThULEP (P<0.05). There was no heterogeneity in postoperative PVR, IPSS, QOL, Qmax, PSA, incidence rate of complications, enucleation time, and extubation time (I²=0%-46%), and there was heterogeneity in operation time (I²=92%). Conclusion　The efficacies and safety of HoLEP and ThULEP in the treatment of benign prostatic hyperplasia are similar, but ThULEP has shorter enucleation time and less intraoperative bleeding than HoLEP.

Key words:

Benign prostatic hyperplasia, Laser enucleation, Holmium laser, Thulium laser, Clinical efficacy, Safety, Meta-analysis

摘要：

目的　比较钬激光剜除术（HoLEP）与铥激光剜除术（ThULEP）治疗良性前列腺增生的疗效及安全性。方法　检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方数据库、维普数据库，收集HoLEP与ThULEP治疗良性前列腺增生的临床研究，检索时间为建库至2024年4月。采用Cochrane偏倚风险评估工具对纳入文献进行方法学质量评价，利用RevMan 5.4.1软件对纳入数据进行统计学分析。结果　共纳入11篇文献，涉及良性前列腺增生患者2 029例。meta分析结果显示，HoLEP与ThULEP患者残余尿量（PVR）、国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）、前列腺特异性抗原（PSA）、并发症发生率、手术时间及拔管时间比较，差异均无统计学意义（均P>0.05）。HoLEP患者剜除时间长于ThULEP患者，术中出血量多于ThULEP患者（均P<0.05），且各研究间患者术后PVR、IPSS、QOL、Qmax、PSA、并发症发生率、剜除时间及拔管时间无异质性（I²=0%～46%），手术时间存在异质性（I²=92%）。结论　HoLEP与ThULEP治疗良性前列腺增生的效果及安全性相似，但相比HoLEP，ThULEP的剜除时间更短，术中出血量更少。

关键词:

良性前列腺增生, 激光剜除术, 钬激光, 铥激光, 临床疗效, 安全性, meta分析

Wang Jike, Liu Jinbo.

Efficacies and safety of holmium and thulium laser enucleation in treatment of benign prostatic hyperplasia: a meta-analysis [J]. International Medicine and Health Guidance News, 2025, 31(6): 930-939.

王纪科刘锦波.

钬激光与铥激光剜除术治疗良性前列腺增生疗效及安全性的meta分析 [J]. 国际医药卫生导报, 2025, 31(6): 930-939.

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