最少侵入性良性前列腺增生疗法后的重新干预率:包括行业参与的系统审查
Burak Akgul1, Atınc Tozsin1, Abdullatif Aydın2
1Department of Urology, Trakya University School of Medicine, Edirne, Turkey.
World journal of urology
|August 16, 2025
概括
良性前列腺增生症 (BPH) 的最小侵入性手术疗法显示出不同的重新干预率. 奥普蒂卢姆BPH导管系统 (OBCS),水化和水蒸气热疗法 (WVTT) 显示较低的率,而行业赞助可能会导致结果偏差.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 良性前列腺增生症 (BPH) 管理
背景情况:
- 最少侵入性外科治疗 (MIST) 为良性前列腺增生 (BPH) 提供了传统手术的替代方案.
- 长期的再干预率和行业赞助的影响是BPH治疗临床决策的关键因素.
研究的目的:
- 系统地评估BPH的MIST后的手术重新干预率.
- 为了评估MIST后的药物治疗启动率.
- 分析行业赞助对研究结果和客观性的影响.
主要方法:
- 从MEDLINE,EMBASE和Cochrane图书馆对前性和后性研究进行系统审查,直到2024年12月.
- 在研究选择和数据提取方面遵循了PRISMA指南.
- 对利益冲突 (COI) 的风险分析和赞助商对研究结果的影响.
主要成果:
- 重新干预的比率有所不同:前列腺动脉栓塞 (PAE) 21% (2年),尿道外微波疗法 (TUMT) 67% (5年),尿道外针切除 (TUNA) 13.8%-26.4% (5-10年).
- 对于Optilume BPH导管系统 (OBCS) 观察到的较低率为2.5% (2年),水化 4.4%-6% (5年) 和水蒸气热疗法 (WVTT) 11.1% (5年).
- 在65%的研究中,工业赞助被确定为高风险,其中52%显示赞助商的影响,引发了客观性的担忧.
结论:
- 与PAE,TUMT和TUNA相比,OBCS,Aquablation和WVTT显示出有希望的较低的再干预率.
- 行业赞助的研究可能会由于限制性纳入标准而表现出偏见,这可能会限制对现实世界人口的概括性.
- 临床指南应该谨慎地整合研究结果,考虑潜在的利益冲突和研究方法的变化.
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