通过尿道切除技术在治疗良性前列腺增生症的住院患者中的比较有效性
Christian P Meyer1, David F Friedlander1,2, Ye Wang1
1Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
Urology practice
|June 14, 2023
概括
双极切除和GreenLight光蒸发在良性前列腺增生症的单极切除上提供了适度的安全优势. 然而,尽管短期并发症率相似,但这些先进的程序与更高的直接医院成本有关.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术技术 手术技术
- 卫生经济学 卫生经济学
背景情况:
- 单极横尿管切除是良性前列腺扩大的标准.
- 双极切除和GreenLight光蒸发提供了更好的安全性.
- 对于比较这些技术的数据有限,特别是关于成本的数据.
研究的目的:
- 为了比较单极,双极和GreenLight光蒸发用于膀出口阻塞的成本和短期安全性.
- 分析这些手术技术的使用趋势.
主要方法:
- 从大型住院患者数据库分析了20323名40至80岁的男性,他们接受了出门手术 (2003-2013).
- 利用倾向权重后勤回归来评估安全结果和治疗趋势.
- 操作时间,停留时间,90天并发症率和直接医院费用的比较.
主要成果:
- 单极切除术的使用减少了20%,但仍然是最常见的.
- 双极切除在手术时间,停留时间或90天并发症方面与单极切除没有显著差异.
- 绿光光蒸发的手术时间更长,但住院时间更短,降低了低血量,狭窄和前列腺炎的风险.
- 双极切除和绿光切除都会比单极切除产生更高的90天直接医院费用.
结论:
- 与单极切除相比,双极切除和GreenLight光蒸发提供了适度的外科手术期间安全优势.
- 尽管有安全益处,但这两种替代程序都与直接医院成本的增加有关.
- 程序的选择包括平衡安全改进与经济考虑.
相关概念视频
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
78
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
78
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
16
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
16
01:25Urinary Tract Calculi VI: Surgical Management
11
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
11