前立腺肥大症に対するThulium laser前立腺核出術 (ThuLEP) vs. TUR-P : 無作為化比較試験の現状
【目的】BPHに対するThuLEPとBipolar TUR-Pの比較試験の現状を報告する.【対象と方法】対象は, BPHに対して手術療法が必要となった症例. ThuLEP群およびTUR-P群を比較した.【結果】ThuLEP群 (n＝55) およびTUR-P群 (n＝55) において, 排尿状態は, 術後に有意な改善が認められた. 一方, ThuLEP群は術前後のHb減少量が少なく (P＝0.032), カテーテル留置期間は短期間であった (P＝0.048). また, ThuLEP群では, 術後3カ月目以上に勃起機能の回復が認められた.【考察】ThuLEPおよびTUR-P群ともに治療効果は同等で...
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| Published in | Japanese Journal of Endourology Vol. 33; no. 2; pp. 341 - 346 |
|---|---|
| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本泌尿器内視鏡学会
2020
Japanese Society of Endourology |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2186-1889 2187-4700 |
| DOI | 10.11302/jsejje.33.341 |
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| Abstract | 【目的】BPHに対するThuLEPとBipolar TUR-Pの比較試験の現状を報告する.【対象と方法】対象は, BPHに対して手術療法が必要となった症例. ThuLEP群およびTUR-P群を比較した.【結果】ThuLEP群 (n＝55) およびTUR-P群 (n＝55) において, 排尿状態は, 術後に有意な改善が認められた. 一方, ThuLEP群は術前後のHb減少量が少なく (P＝0.032), カテーテル留置期間は短期間であった (P＝0.048). また, ThuLEP群では, 術後3カ月目以上に勃起機能の回復が認められた.【考察】ThuLEPおよびTUR-P群ともに治療効果は同等であったが, 止血, カテーテル留置期間, および勃起温存において, ThuLEPの有用性が示唆された. |
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| AbstractList | Objective : To report the on-going status of randomized prospective study compared functional outcomes and complications over 12 months in BPH treated with ThuLEP or bipolar TURP.Methods : We evaluated functional outcomes in 110 patients with BPH, in a randomized prospective study using IPSS, IPSS QOL, OABSS, uroflowmetry, and IIEF-5. Scores were taken before treatment and at 1, 3, 6, 9 and 12 months afterward.Results : Both groups had significantly improved IPSS, IPSS QOL, OABSS, and uroflowmetry compared with pre-operative values. The ThuLEP group had lower median decrease in Hb (0.2 g/dL vs. 0.8 g/dL, P＝0.032) and shorter median catheterization (1 day vs. 2 days, P＝0.048) than the bipolar TURP group. In the ThuLEP group, erectile function was significantly impaired at 1 month post-treatment compared with pre-treatment, but improved to baseline at 3 months.Conclusions : ThuLEP is superior to bipolar TURP in hemostasis, catheterization time, and preservation of erectile function in the progress report.
【目的】BPHに対するThuLEPとBipolar TUR-Pの比較試験の現状を報告する.【対象と方法】対象は, BPHに対して手術療法が必要となった症例. ThuLEP群およびTUR-P群を比較した.【結果】ThuLEP群 (n＝55) およびTUR-P群 (n＝55) において, 排尿状態は, 術後に有意な改善が認められた. 一方, ThuLEP群は術前後のHb減少量が少なく (P＝0.032), カテーテル留置期間は短期間であった (P＝0.048). また, ThuLEP群では, 術後3カ月目以上に勃起機能の回復が認められた.【考察】ThuLEPおよびTUR-P群ともに治療効果は同等であったが, 止血, カテーテル留置期間, および勃起温存において, ThuLEPの有用性が示唆された. 「要旨」【目的】BPHに対するThuLEPとBipolar TUR-Pの比較試験の現状を報告する. 【対象と方法】対象は, BPHに対して手術療法が必要となった症例. ThuLEP群およびTUR-P群を比較した. 【結果】ThuLEP群 (n=55) およびTUR-P群 (n=55) において, 排尿状態は, 術後に有意な改善が認められた. 一方, ThuLEP群は術前後のHb減少量が少なく (P=0.032) , カテーテル留置期間は短期間であった (P=0.048) . また, ThuLEP群では, 術後3カ月目以上に勃起機能の回復が認められた. 【考察】ThuLEPおよびTUR-P群ともに治療効果は同等であったが, 止血, カテーテル留置期間, および勃起温存において, ThuLEPの有用性が示唆された. 【目的】BPHに対するThuLEPとBipolar TUR-Pの比較試験の現状を報告する.【対象と方法】対象は, BPHに対して手術療法が必要となった症例. ThuLEP群およびTUR-P群を比較した.【結果】ThuLEP群 (n＝55) およびTUR-P群 (n＝55) において, 排尿状態は, 術後に有意な改善が認められた. 一方, ThuLEP群は術前後のHb減少量が少なく (P＝0.032), カテーテル留置期間は短期間であった (P＝0.048). また, ThuLEP群では, 術後3カ月目以上に勃起機能の回復が認められた.【考察】ThuLEPおよびTUR-P群ともに治療効果は同等であったが, 止血, カテーテル留置期間, および勃起温存において, ThuLEPの有用性が示唆された. |
| Author | 内田, 貴人 小川, 貴博 日暮, 太朗 小路, 直 武田, 和真 黒田, 悟史 長谷川, 政徳 花田, いずみ 川上, 正能 宮嶋, 哲 河村, 好章 中野, まゆら 新田, 正広 杠, 総一郎 |
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| References | 11) Aus G, Bergdahl S, Frosing R, et al. (1996) Reference range of prostate-specific antigen after transurethral resection of the prostate. Urology 47 : 529-531 20) Bozzini G, Seveso M, Melegari S, et al. (2017) Thulium laser enucleation (ThuLEP) versus transurethral resection of the prostate in saline (TURis) : A randomized prospective trial to compare intra and early postoperative outcomes. Actas Urol Esp 41 : 309-315 1) 日本泌尿器科学会監修 (2017) 男性下部尿路症状・前立腺肥大症診療ガイドライン, リッチヒルメディカル, 東京, pp. 148-149 10) Ozden C, Inal G, Adsan O, et al. (2003) Detection of prostate cancer and changes in prostate-specific antigen (PSA) six months after surgery for benign prostatic hyperplasia in patients with elevated PSA. Urol Int 71 : 150-153 7) Saredi G, Pacchetti A, Pirola GM, et al. (2016) Impact of thulium laser enucleation of the prostate on erectile, ejaculatory and urinary functions. Urol Int 97 : 397-401 8) Iacono F, Prezioso D, Di Lauro G, et al. (2012) Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients. BMC Surg 12 (Suppl 1) : S21 16) Liu Y, Cheng Y, Zhuo L, et al. (2020) Impact on sexual function of endoscopic enucleation vs transurethral resection of the prostate for lower urinary tract symptoms due to benign prostatic hyperplasia : a systematic review and meta-analysis. J Endourol, In Press 9) Zhang F, Shao Q, Herrmann TR, et al. (2012) Thulium laser versus holmium laser transurethral enucleation of the prostate : 18-month follow-up data of a single center. Urology 79 : 869-874 3) Rausch S, Heider T, Bedke J, et al. (2015) Analysis of early morbidity and functional outcome of thulium : yttrium-aluminum-garnet laser enucleation for benign prostate enlargement : patient age and prostate size determine adverse surgical outcome. Urology 85 : 182-188 13) Yang Z, Liu T, Wang X (2016) Comparison of thulium laser enucleation and plasmakinetic resection of the prostate in a randomized prospective trial with 5-year follow-up. Lasers Med Sci 31 : 1797-1802 15) Liu Z, Li YW, Wu WR, et al. (2017) Long-term clinical efficacy and safety profile of transurethral resection of prostate versus plasmakinetic resection of the prostate for benign prostatic hyperplasia. Urology 103 : 198-203 4) Ketan PV, Prashant HS (2016) Thulium laser enucleation of the prostate is a safe and a highly effective modality for the treatment of benign prostatic hyperplasia - Our experience of 236 patients. Urol Ann 8 : 76-80 19) Miura Y, Seifert E, Rehra J, et al. (2019) Real-time optoacoustic temperature determination on cell cultures during heat exposure : a feasibility study. Int J Hyperthermia 36 : 466-472 18) Rieken M, Ebinger Mundorff N, Bonkat G, et al. (2010) Complications of laser prostatectomy : a review of recent data. World J Urol 28 : 53-62 6) Raber M, Buchholz NNP, Vercesi A, et al. (2018) Thulium laser enucleation of the prostate (ThuLEP) : Results, complications, and risk factors in 139 consecutive cases. Arab J Urol 16 : 411-416 2) Herrmann TR, Bach T, Imkamp F, et al. (2010) Thulium laser enucleation of the prostate (ThuLEP) : transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol 28 : 45-51 17) Carmignani L, Bozzini G, Macchi A, et al. (2015) Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia. Asian J Androl 17 : 802-806 12) Swiniarski PP, Stepien S, Dudzic W, et al. (2012) Thulium laser enucleation of the prostate (TmLEP) vs. transurethral resection of the prostate (TURP) : evaluation of early results. Cent European J Urol 65 : 130-134 14) Xia SJ, Zhuo J, Sun XW, et al. (2008) Thulium laser versus standard transurethral resection of the prostate : a randomized prospective trial. Eur Urol 53 : 382-389 5) Carmignani L, Pastore AL, Picozzi SC, et al. (2016) Thulium laser prostate enucleation in refractory urinary retention : Operative and functional outcomes in a large cohort of patients. Urology 93 : 152-157 |
| References_xml | – reference: 5) Carmignani L, Pastore AL, Picozzi SC, et al. (2016) Thulium laser prostate enucleation in refractory urinary retention : Operative and functional outcomes in a large cohort of patients. Urology 93 : 152-157 – reference: 6) Raber M, Buchholz NNP, Vercesi A, et al. (2018) Thulium laser enucleation of the prostate (ThuLEP) : Results, complications, and risk factors in 139 consecutive cases. Arab J Urol 16 : 411-416 – reference: 3) Rausch S, Heider T, Bedke J, et al. (2015) Analysis of early morbidity and functional outcome of thulium : yttrium-aluminum-garnet laser enucleation for benign prostate enlargement : patient age and prostate size determine adverse surgical outcome. Urology 85 : 182-188 – reference: 20) Bozzini G, Seveso M, Melegari S, et al. (2017) Thulium laser enucleation (ThuLEP) versus transurethral resection of the prostate in saline (TURis) : A randomized prospective trial to compare intra and early postoperative outcomes. Actas Urol Esp 41 : 309-315 – reference: 2) Herrmann TR, Bach T, Imkamp F, et al. (2010) Thulium laser enucleation of the prostate (ThuLEP) : transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol 28 : 45-51 – reference: 7) Saredi G, Pacchetti A, Pirola GM, et al. (2016) Impact of thulium laser enucleation of the prostate on erectile, ejaculatory and urinary functions. Urol Int 97 : 397-401 – reference: 10) Ozden C, Inal G, Adsan O, et al. (2003) Detection of prostate cancer and changes in prostate-specific antigen (PSA) six months after surgery for benign prostatic hyperplasia in patients with elevated PSA. Urol Int 71 : 150-153 – reference: 11) Aus G, Bergdahl S, Frosing R, et al. (1996) Reference range of prostate-specific antigen after transurethral resection of the prostate. Urology 47 : 529-531 – reference: 1) 日本泌尿器科学会監修 (2017) 男性下部尿路症状・前立腺肥大症診療ガイドライン, リッチヒルメディカル, 東京, pp. 148-149 – reference: 14) Xia SJ, Zhuo J, Sun XW, et al. (2008) Thulium laser versus standard transurethral resection of the prostate : a randomized prospective trial. Eur Urol 53 : 382-389 – reference: 17) Carmignani L, Bozzini G, Macchi A, et al. (2015) Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia. Asian J Androl 17 : 802-806 – reference: 4) Ketan PV, Prashant HS (2016) Thulium laser enucleation of the prostate is a safe and a highly effective modality for the treatment of benign prostatic hyperplasia - Our experience of 236 patients. Urol Ann 8 : 76-80 – reference: 16) Liu Y, Cheng Y, Zhuo L, et al. (2020) Impact on sexual function of endoscopic enucleation vs transurethral resection of the prostate for lower urinary tract symptoms due to benign prostatic hyperplasia : a systematic review and meta-analysis. J Endourol, In Press – reference: 15) Liu Z, Li YW, Wu WR, et al. (2017) Long-term clinical efficacy and safety profile of transurethral resection of prostate versus plasmakinetic resection of the prostate for benign prostatic hyperplasia. Urology 103 : 198-203 – reference: 19) Miura Y, Seifert E, Rehra J, et al. (2019) Real-time optoacoustic temperature determination on cell cultures during heat exposure : a feasibility study. Int J Hyperthermia 36 : 466-472 – reference: 13) Yang Z, Liu T, Wang X (2016) Comparison of thulium laser enucleation and plasmakinetic resection of the prostate in a randomized prospective trial with 5-year follow-up. Lasers Med Sci 31 : 1797-1802 – reference: 18) Rieken M, Ebinger Mundorff N, Bonkat G, et al. (2010) Complications of laser prostatectomy : a review of recent data. World J Urol 28 : 53-62 – reference: 8) Iacono F, Prezioso D, Di Lauro G, et al. (2012) Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients. BMC Surg 12 (Suppl 1) : S21 – reference: 12) Swiniarski PP, Stepien S, Dudzic W, et al. (2012) Thulium laser enucleation of the prostate (TmLEP) vs. transurethral resection of the prostate (TURP) : evaluation of early results. Cent European J Urol 65 : 130-134 – reference: 9) Zhang F, Shao Q, Herrmann TR, et al. (2012) Thulium laser versus holmium laser transurethral enucleation of the prostate : 18-month follow-up data of a single center. Urology 79 : 869-874 |
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| Snippet | 【目的】BPHに対するThuLEPとBipolar TUR-Pの比較試験の現状を報告する.【対象と方法】対象は, BPHに対して手術療法が必要となった症例. ThuLEP群およびTUR-P群を比較した.【結果】ThuLEP群 (n＝55) およびTUR-P群 (n＝55) において, 排尿状態は,... 「要旨」【目的】BPHに対するThuLEPとBipolar TUR-Pの比較試験の現状を報告する. 【対象と方法】対象は, BPHに対して手術療法が必要となった症例. ThuLEP群およびTUR-P群を比較した. 【結果】ThuLEP群 (n=55) およびTUR-P群 (n=55) において, 排尿状態は,... Objective : To report the on-going status of randomized prospective study compared functional outcomes and complications over 12 months in BPH treated with... |
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| StartPage | 341 |
| SubjectTerms | ツリウムレーザー 前立腺肥大症 性機能 排尿機能 経尿道的前立腺切除術 |
| Title | 前立腺肥大症に対するThulium laser前立腺核出術 (ThuLEP) vs. TUR-P : 無作為化比較試験の現状 |
| URI | https://www.jstage.jst.go.jp/article/jsejje/33/2/33_341/_article/-char/ja http://mol.medicalonline.jp/library/journal/download?GoodsID=cs5jjend/2020/003302/033&name=0341-0346j https://cir.nii.ac.jp/crid/1390567901496178432 |
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| ispartofPNX | Japanese Journal of Endourology, 2020, Vol.33(2), pp.341-346 |
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