Serveur d'exploration sur le thulium

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Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis

Identifieur interne : 000B21 ( Ncbi/Merge ); précédent : 000B20; suivant : 000B22

Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis

Auteurs : Xingming Zhang ; Pengfei Shen ; Qiying He ; Xiaoxue Yin ; Zhibin Chen ; Haojun Gui ; Kunpeng Shu ; Qidun Tang ; Yaojing Yang ; Xiuyi Pan ; Jia Wang ; Ni Chen ; Hao Zeng

Source :

RBID : PMC:4806333

Abstract

All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions.


Url:
DOI: 10.1038/srep23503
PubMed: 27009501
PubMed Central: 4806333

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PMC:4806333

Le document en format XML

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<p>All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions.</p>
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<institution>Department of Urology, Institute of Urology, West China Hospital, Sichuan University</institution>
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<institution>Department of Urology, Institute of Urology, West China Hospital, Sichuan University</institution>
, Chengdu,
<country>China</country>
, 610041</nlm:aff>
<wicri:noCountry code="subfield">610041</wicri:noCountry>
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<institution>Department of Urology, Institute of Urology, West China Hospital, Sichuan University</institution>
, Chengdu,
<country>China</country>
, 610041</nlm:aff>
<wicri:noCountry code="subfield">610041</wicri:noCountry>
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<institution>Department of Urology, Institute of Urology, West China Hospital, Sichuan University</institution>
, Chengdu,
<country>China</country>
, 610041</nlm:aff>
<wicri:noCountry code="subfield">610041</wicri:noCountry>
</affiliation>
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<name sortKey="Pan, Xiuyi" sort="Pan, Xiuyi" uniqKey="Pan X" first="Xiuyi" last="Pan">Xiuyi Pan</name>
<affiliation>
<nlm:aff id="a2">
<institution>Department of Pathology, West China Hospital</institution>
<institution>, Sichuan University</institution>
, Chengdu,
<country>China</country>
, 610041</nlm:aff>
<wicri:noCountry code="subfield">610041</wicri:noCountry>
</affiliation>
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<author>
<name sortKey="Wang, Jia" sort="Wang, Jia" uniqKey="Wang J" first="Jia" last="Wang">Jia Wang</name>
<affiliation>
<nlm:aff id="a1">
<institution>Department of Urology, Institute of Urology, West China Hospital, Sichuan University</institution>
, Chengdu,
<country>China</country>
, 610041</nlm:aff>
<wicri:noCountry code="subfield">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Chen, Ni" sort="Chen, Ni" uniqKey="Chen N" first="Ni" last="Chen">Ni Chen</name>
<affiliation>
<nlm:aff id="a2">
<institution>Department of Pathology, West China Hospital</institution>
<institution>, Sichuan University</institution>
, Chengdu,
<country>China</country>
, 610041</nlm:aff>
<wicri:noCountry code="subfield">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Zeng, Hao" sort="Zeng, Hao" uniqKey="Zeng H" first="Hao" last="Zeng">Hao Zeng</name>
<affiliation>
<nlm:aff id="a1">
<institution>Department of Urology, Institute of Urology, West China Hospital, Sichuan University</institution>
, Chengdu,
<country>China</country>
, 610041</nlm:aff>
<wicri:noCountry code="subfield">610041</wicri:noCountry>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Scientific Reports</title>
<idno type="eISSN">2045-2322</idno>
<imprint>
<date when="2016">2016</date>
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<front>
<div type="abstract" xml:lang="en">
<p>All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions.</p>
</div>
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<name sortKey="Zhang, Xingming" sort="Zhang, Xingming" uniqKey="Zhang X" first="Xingming" last="Zhang">Xingming Zhang</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
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<name sortKey="Shen, Pengfei" sort="Shen, Pengfei" uniqKey="Shen P" first="Pengfei" last="Shen">Pengfei Shen</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
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</author>
<author>
<name sortKey="He, Qiying" sort="He, Qiying" uniqKey="He Q" first="Qiying" last="He">Qiying He</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Yin, Xiaoxue" sort="Yin, Xiaoxue" uniqKey="Yin X" first="Xiaoxue" last="Yin">Xiaoxue Yin</name>
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<nlm:affiliation>Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
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</author>
<author>
<name sortKey="Chen, Zhibin" sort="Chen, Zhibin" uniqKey="Chen Z" first="Zhibin" last="Chen">Zhibin Chen</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
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</author>
<author>
<name sortKey="Gui, Haojun" sort="Gui, Haojun" uniqKey="Gui H" first="Haojun" last="Gui">Haojun Gui</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
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<author>
<name sortKey="Shu, Kunpeng" sort="Shu, Kunpeng" uniqKey="Shu K" first="Kunpeng" last="Shu">Kunpeng Shu</name>
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<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Tang, Qidun" sort="Tang, Qidun" uniqKey="Tang Q" first="Qidun" last="Tang">Qidun Tang</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Yang, Yaojing" sort="Yang, Yaojing" uniqKey="Yang Y" first="Yaojing" last="Yang">Yaojing Yang</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Pan, Xiuyi" sort="Pan, Xiuyi" uniqKey="Pan X" first="Xiuyi" last="Pan">Xiuyi Pan</name>
<affiliation>
<nlm:affiliation>Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
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</author>
<author>
<name sortKey="Wang, Jia" sort="Wang, Jia" uniqKey="Wang J" first="Jia" last="Wang">Jia Wang</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Chen, Ni" sort="Chen, Ni" uniqKey="Chen N" first="Ni" last="Chen">Ni Chen</name>
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<nlm:affiliation>Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
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<name sortKey="Zeng, Hao" sort="Zeng, Hao" uniqKey="Zeng H" first="Hao" last="Zeng">Hao Zeng</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
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<name sortKey="Shen, Pengfei" sort="Shen, Pengfei" uniqKey="Shen P" first="Pengfei" last="Shen">Pengfei Shen</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="He, Qiying" sort="He, Qiying" uniqKey="He Q" first="Qiying" last="He">Qiying He</name>
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<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Yin, Xiaoxue" sort="Yin, Xiaoxue" uniqKey="Yin X" first="Xiaoxue" last="Yin">Xiaoxue Yin</name>
<affiliation>
<nlm:affiliation>Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Chen, Zhibin" sort="Chen, Zhibin" uniqKey="Chen Z" first="Zhibin" last="Chen">Zhibin Chen</name>
<affiliation>
<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Gui, Haojun" sort="Gui, Haojun" uniqKey="Gui H" first="Haojun" last="Gui">Haojun Gui</name>
<affiliation>
<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Shu, Kunpeng" sort="Shu, Kunpeng" uniqKey="Shu K" first="Kunpeng" last="Shu">Kunpeng Shu</name>
<affiliation>
<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Tang, Qidun" sort="Tang, Qidun" uniqKey="Tang Q" first="Qidun" last="Tang">Qidun Tang</name>
<affiliation>
<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Yang, Yaojing" sort="Yang, Yaojing" uniqKey="Yang Y" first="Yaojing" last="Yang">Yaojing Yang</name>
<affiliation>
<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Pan, Xiuyi" sort="Pan, Xiuyi" uniqKey="Pan X" first="Xiuyi" last="Pan">Xiuyi Pan</name>
<affiliation>
<nlm:affiliation>Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Wang, Jia" sort="Wang, Jia" uniqKey="Wang J" first="Jia" last="Wang">Jia Wang</name>
<affiliation>
<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Chen, Ni" sort="Chen, Ni" uniqKey="Chen N" first="Ni" last="Chen">Ni Chen</name>
<affiliation>
<nlm:affiliation>Department of Pathology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Zeng, Hao" sort="Zeng, Hao" uniqKey="Zeng H" first="Hao" last="Zeng">Hao Zeng</name>
<affiliation>
<nlm:affiliation>Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China, 610041.</nlm:affiliation>
<wicri:noCountry code="subField">610041</wicri:noCountry>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Scientific reports</title>
<idno type="eISSN">2045-2322</idno>
<imprint>
<date when="2016" type="published">2016</date>
</imprint>
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<front>
<div type="abstract" xml:lang="en">All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions.</div>
</front>
</TEI>
</pubmed>
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