经尿道双极等离子前列腺剜除术与电切术治疗体积大于60 mL前列腺增生的安全性与有效性的Meta分析

目的 探讨经尿道等离子双极前列腺剜除术（PKEP）与经尿道等离子双极前列腺电切术（PKRP）治疗体积>60mL良性前列腺增生（BPH）的安全性与有效性。方法 检索国内外各大常用数据库中比较PKEP与PKRP治疗体积>60mLBPH的随机对照研究（RCT），检索日期为2012年1月1日至2017年3月2日，按照纳入排除标准进行文献筛选和数据提取，并进行文献质量评价，使用RevMan5.3软件进行Meta分析。结果 与PKRP相比，PKEP的前列腺切除质量较多｛WMD=15.29，95%CI（9.18，21.40），P<0.001｝，手术时间较短｛WMD=-17.44，95%CI（-28.69，-6.19），P=0.002｝，留置导尿管时间较短｛WMD=-26.51，95%CI（-36.49，-16.54），P<0.001｝，术中出血量较少｛WMD=-77.82，95%CI（-120.90，-34.74），P<0.001｝，住院天数较少及术后最大尿流率较大，但后两者敏感性较低。PKEP与PKRP术后并发症发生率无统计学差异。结论 比较PKEP与PKRP治疗体积>60mLBPH，PKEP切除前列腺增生腺体更完全，所需手术时间短，留置导尿管时间较短，术中出血量少，较PKRP安全有效，但由于原始研究质量较低，后期仍需大量高质量、大样本RCT验证后方可进一步临床推广。

Safety and efficacy of plasmakinetic enucleation of prostate versus plasmakinetic resection of prostate in treating patients with prostate gland larger than 60 milliliters:a meta-analysis

Objective To evaluate the safety and efficacy of plasmakinetic enucleation of prostate （PKEP）vs plasmakinetic resection of prostate （PKRP）in treating benign prostatic hyperplasia （BPH） which volume was larger than 60 ml. Methods Databases were searched from 2012/01/01 to 2017/03/02 for collecting the randomized controlled trials about PKEP vs PKRP for the treatment of BPH with volume larger than 60 ml, and then selected the literatures using bringing in and ruling out standard, assessing them and extracting data. Meta-analysis was performed by using the RevMan 5.3. Results Compared with PKRP, PKEP had more resection hyperplastic tissue（WMD=15.29, 95% CI:9.18, 21.40, P<0.001）, shorter operation time （WMD=-17.44, 95% CI:-28.69, -6.19, P=0.002）, shorter catheter time （WMD=-26.51, 95% CI:-36.49, -16.54, P<0.001）, less intraoperative bleeding （WMD=-77.82, 95% CI:-120.90, -34.74, P=0.0004）, but there was no significant difference in the incidence of postoperative complications between PKEP and PKRP. Conclusion Compared with PKRP for the treatment of BPH which volume is larger than 60 ml, PKEP had more resection hyperplastic tissue, shorter operation time, shorter catheter time, less intraoperative bleeding. But because the original research quality is poor, higher quality, large sample RCT studies are need before clinic promotion.