International urology and nephrology · 2025
En-bloc and non-en-bloc techniques for thulium laser enucleation of the prostate: a comparative study of surgical outcomes.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Song Haitian, Li Zhicun, Che Xinyan, Chen Kaiyue, Yang Kunlin, Zuo Chao, Zhang Qian, Zhang Kai, Meng Yisen
Аннотация
OBJECTIVES: To compare surgical outcomes between the en-bloc and non-en-bloc techniques of thulium laser enucleation of the prostate (ThuLEP) in patients with different prostate volumes (PV).
METHODS: We reviewed patients treated with ThuLEP for benign prostatic hyperplasia (BPH) at Peking University First Hospital from January 2020 to December 2022. Patients were categorized into en-bloc and non-en-bloc (the two-lobe and three-lobe techniques) according to enucleation techniques. Baseline characteristics, peri-operative and post-operative outcomes were evaluated. Subgroup analysis were conducted based on prostate volume (PV < 60 ml, 60 ≤ PV < 80 ml, and PV ≥ 80 ml). Propensity score matching (PSM) was used to reduce confounding.
RESULTS: A total of 540 patients were included with 196 patients undergoing en-bloc enucleation and 344 patients undergoing non-en-bloc enucleation. The baseline characteristics between the two groups were similar. The en-bloc technique demonstrated reduced operation time (median: 59.0 vs. 78.0 min, P < 0.001) and increased operation efficiency (median: 0.84 vs. 0.63 g/min, P < 0.001) compared to the non-en-bloc techniques, with similar post-operative complication rates (6.1% vs. 4.7%, P = 0.458). Sub-group analysis based on prostate volume revealed that the en-bloc technique resulted in decreased operation time and improved operation efficiency for patients with PV > 80 ml and between 60 and 80 ml. However, no significant difference was observed between en-bloc and non-en-bloc techniques for patients with PV ≤ 60 ml.
CONCLUSIONS: In patients with PV > 60 ml, the en-bloc technique is advantageous in operation time and efficiency compared to non-en-bloc techniques. For those with PV < 60 ml, the en-bloc and non-en-bloc techniques exhibit similar operation time and efficiency.
METHODS: We reviewed patients treated with ThuLEP for benign prostatic hyperplasia (BPH) at Peking University First Hospital from January 2020 to December 2022. Patients were categorized into en-bloc and non-en-bloc (the two-lobe and three-lobe techniques) according to enucleation techniques. Baseline characteristics, peri-operative and post-operative outcomes were evaluated. Subgroup analysis were conducted based on prostate volume (PV < 60 ml, 60 ≤ PV < 80 ml, and PV ≥ 80 ml). Propensity score matching (PSM) was used to reduce confounding.
RESULTS: A total of 540 patients were included with 196 patients undergoing en-bloc enucleation and 344 patients undergoing non-en-bloc enucleation. The baseline characteristics between the two groups were similar. The en-bloc technique demonstrated reduced operation time (median: 59.0 vs. 78.0 min, P < 0.001) and increased operation efficiency (median: 0.84 vs. 0.63 g/min, P < 0.001) compared to the non-en-bloc techniques, with similar post-operative complication rates (6.1% vs. 4.7%, P = 0.458). Sub-group analysis based on prostate volume revealed that the en-bloc technique resulted in decreased operation time and improved operation efficiency for patients with PV > 80 ml and between 60 and 80 ml. However, no significant difference was observed between en-bloc and non-en-bloc techniques for patients with PV ≤ 60 ml.
CONCLUSIONS: In patients with PV > 60 ml, the en-bloc technique is advantageous in operation time and efficiency compared to non-en-bloc techniques. For those with PV < 60 ml, the en-bloc and non-en-bloc techniques exhibit similar operation time and efficiency.