Network meta-analysis of the treatment safety and efficacy of different energy systems in prostate vaporization

AbstractMany clinical trials and meta-analyses have examined vaporization with different energy instruments has been recognized by the American Urological Association (AUA) and the European Association of Urology (EAU) as a promising treatment for benign prostate hyperplasia. However, there is still a lack of evidence for a network comparison between different vaporization devices. The PubMed, Embase, Cochrane and Web of Science databases were searched to identify randomized controlled trials (RCTs) of different energy systems for prostate vaporization. Pairwise and network meta-analyses (NMA) were performed to analyze the outcome regarding surgery time, complications, short-term maximum urine flow rate (Qmax), and long-termQmax. The Stata software was used for paired meta-analysis. A Bayesian NMA model with ADDIS software was applied to achieve the indirect comparison of different energy systems. Node-splitting analysis and inconsistency factors were used to test inconsistency for closed-loop indirect comparison. Fifteen studies were included in this study, involving three types of energy systems used in prostate vaporization: diode laser (wavelength: 980  nm, power: 200–300 W, mode: continuous), green-light laser (wavelength: 532 nm, power: 80–180 W, mode: continuous), and bipolar plasma vaporization (bipolar electrode, power: 270–280 W, mode: pulsed). In the conventional paired meta-analysis, significantly better short-term efficacy was fou nd in green light laser ...
Source: Lasers in Medical Science - Category: Laser Surgery Source Type: research