APC-PKEP用于治疗合并中重度LUTS症状BPH患者的安全性和疗效:一项改良犁形电极PKEP、B-TURP和HoLEP治疗的多中心、前瞻性随机对照研究

注册号:

Registration number:

ChiCTR2600122760 

最近更新日期:

Date of Last Refreshed on:

2026-04-17 10:23:40 

注册时间:

Date of Registration:

2026-04-17 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

APC-PKEP用于治疗合并中重度LUTS症状BPH患者的安全性和疗效:一项改良犁形电极PKEP、B-TURP和HoLEP治疗的多中心、前瞻性随机对照研究

Public title:

Safety and Efficacy of APC-PKEP for the Treatment of Patients with BPH Complicated by Moderate-to-Severe LUTS: A Multicenter, Prospective, Randomized Controlled Trial Comparing Modified Plow-Shaped Electrode PKEP, B-TURP, and HoLEP

注册题目简写:

一项改良犁形电极PKEP、B-TURP和HoLEP治疗的多中心、前瞻性随机对照研究

English Acronym:

A Multicenter, Prospective, Randomized Controlled Trial Comparing Treatment with the Modified Plow-Shaped Electrode (PKEP), B-TURP, and HoLEP

研究课题的正式科学名称:

APC-PKEP用于治疗合并中重度LUTS症状BPH患者的疗效和安全性:一项改良犁形电极PKEP、B-TURP和HoLEP治疗的比较研究

Scientific title:

Efficacy and Safety of APC-PKEP in the Treatment of Patients with BPH Complicated by Moderate-to-Severe LUTS: A Comparative Study of Modified Plow-Shaped Electrode PKEP, B-TURP, and HoLEP

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

翁靖宇 

研究负责人:

吴进锋 

Applicant:

Weng Jingyu 

Study leader:

Wu Jinfeng 

申请注册联系人电话:

Applicant telephone:

+86 591 8861 8618

研究负责人电话:

Study leader's
telephone:

+86 591 8861 8618

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

jingyw20250101@163.com

研究负责人电子邮件:

Study leader's E-mail:

wjf54007@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国福建省福州市鼓楼区东街134号

研究负责人通讯地址:

中国福建省福州市鼓楼区东街134号

Applicant address:

134 Dong Street, Gulou District, Fuzhou, Fujian, China

Study leader's address:

134 Dong Street, Gulou District, Fuzhou, Fujian, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

福州大学附属省立医院

Applicant's institution:

Fuzhou University Affiliated Provincial Hospital

研究负责人所在单位:

福州大学附属省立医院

Affiliation of the Leader:

Fuzhou University Affiliated Provincial Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

K2024-09-077

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

福州大学附属省立医院伦理委员会

Name of the ethic committee:

Ethics Committee of Provincial Hospital Affiliated to Fuzhou University

伦理委员会批准日期:

Date of approved by ethic committee:

2024-09-26 00:00:00

伦理委员会联系人:

练发杨

Contact Name of the ethic committee:

Lian Fayang

伦理委员会联系地址:

中国福建省福州市鼓楼区秘书巷12号

Contact Address of the ethic committee:

12 Mishu Xiang, Gulou District, Fuzhou, Fujian, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 591 8821 6023

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

福州大学附属省立医院

Primary sponsor:

Fuzhou University Affiliated Provincial Hospital

研究实施负责(组长)单位地址:

中国福建省福州市鼓楼区东街134号

Primary sponsor's address:

134 Dong Street, Gulou District, Fuzhou, Fujian, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

福建

市(区县):

Country:

China

Province:

Fujian

City:

单位(医院):

福州大学附属省立医院

具体地址:

中国福建省福州市鼓楼区东街134号

Institution
hospital:

Fuzhou University Affiliated Provincial Hospital

Address:

134 Dong Street, Gulou District, Fuzhou, Fujian, China

经费或物资来源:

福建省科技创新联合资金

Source(s) of funding:

Fujian Provincial Joint Fund for Scientific and Technological Innovation

研究疾病:

前列腺疾病  

Target disease:

Prostate Diseases

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

主要目标:评价改良犁形电极APC-PKEP与B-TURP、HoLEP相比较治疗BPH患者的安全性 次要目标:评价改良犁形电极APC-PKEP与B-TURP、HoLEP相比较治疗BPH患者的疗效  

Objectives of Study:

Primary Objective: To evaluate the safety of the modified plow-shaped electrode APC-PKEP compared with B-TURP and HoLEP in treating patients with BPH. Secondary Objective: To evaluate the efficacy of the modified plow-shaped electrode APC-PKEP compared with B-TURP and HoLEP in treating patients with BPH.

药物成份或治疗方案详述:

从改良犁形电极前列腺腕除术,双极等离子经尿道前列腺电切术,钬激光前列腺剜除术,三种术式中随机选取一种前期筛选入组的前列腺增生患者进行前列腺切除。其中具体的“前列腺尖部尿道黏膜预离断”术式如下:患者取膀胱截石位,面向患者头部,将前列腺沿矢状面分为1-12点。先在12点位置标记尿道切除位置并切开尿道。在5点位置沿着前列腺左叶和中叶的交汇处找到左叶的包膜层面(利用电极的电凝功能并施加适当压力,尿道粘膜很容易被分离),继而显露前列腺左叶尖部,同法于7点方向显露右叶。沿精阜近端6点方向切开尿道,进入前列腺中叶包膜层面,使其与其他两叶平面相连。至此三个腺叶的远端边界和包膜平面都已显露。沿着 5 点到 12 点方向,用电凝标记前列腺尖部尿道切缘并切开。同理从7点到 12 点方向切开尖部尿道。紧贴前列腺尖部腺体,沿包膜层面分离,直至将前列腺尖部完全游离,完成尖部尿道预离断。从5点到12点方向,继续沿包膜层面游离左叶。由于改良犁型电极具有极佳的硬度,以“边推边剜”的方式可以轻松分离腺体,在电凝的预止血作用下,内镜视野始终保持清晰。如遇纤维条索,可直接切断。切除腺体时,需要在鞘的远端用喙持续顶起游离腺体,以便更好地暴露平面,并在直视下保持张力。沿着包膜层面逆时针分离腺体,直到 12 点方向,并继续向膀胱颈方向延伸。从12点到2点区域切开膀胱黏膜,进入膀胱腔。然后,沿膀胱颈粘膜边缘从2点方向到6点方向继续切割,并注意保持膀胱颈完整。此时,除与中叶交界处外,左叶已完全游离。同样,中叶和右叶也从 5 点方向顺时针逐渐分离到 12 点方向,最后在 12 点方向会师。当腺体较大时,可在中叶和右叶部分离断后,将左叶游离部分推入膀胱腔,从而增加前列腺窝的手术空间。也可直接将左叶与中叶先离断,游离后并分别推入膀胱腔。检查尿道切缘和前列腺腔内,修整创面,彻底止血。使用组织切除器,粉碎并吸出腺体。 

Description for medicine or protocol of treatment in detail:

Patients with benign prostatic hyperplasia who were pre-screened and enrolled were randomly assigned to undergo one of three surgical procedures: modified plow-shaped electrode transurethral resection of the prostate, bipolar plasma transurethral resection of the prostate, or holmium laser enucleation of the prostate. The specific procedure for "pre-dissection of the urethral mucosa at the apex of the prostate" is as follows: The patient is positioned in the lithotomy position, with the surgeon facing the patient’s head. The prostate is divided into 12-point segments along the sagittal plane. First, mark the urethral resection site at the 12 o’clock position and incise the urethra. At the 5 o’clock position, locate the capsular plane of the left lobe along the junction of the left and middle lobes of the prostate (using the electrocoagulation function of the electrode and applying appropriate pressure, the urethral mucosa can be easily dissected), thereby exposing the apex of the left lobe. Use the same method to expose the right lobe at the 7 o’clock position. Incise the urethra at the 6 o’clock position along the proximal aspect of the verum montis to enter the capsular plane of the middle lobe of the prostate, connecting it to the planes of the other two lobes. At this point, the distal borders and capsular planes of all three lobes are exposed. Using electrocoagulation, mark and incise the urethral margin at the apex of the prostate from the 5 o’clock to 12 o’clock positions. Similarly, incise the urethra at the apex from the 7 o’clock to 12 o’clock positions. Adhering closely to the glandular tissue at the apex of the prostate, dissect along the capsular plane until the apical portion is completely mobilized, thereby completing the pre-separation of the apical urethra. Continue mobilizing the left lobe along the capsular plane from the 5 o’clock to 12 o’clock direction. Due to the excellent rigidity of the modified plowshare electrode, the glandular tissue can be easily dissected using a "push-and-scrape" technique; with the hemostatic effect of electrocoagulation, the endoscopic field of view remains clear throughout. If fibrous bands are encountered, they may be cut directly. When resecting the gland, use the beak to continuously lift the dissected gland at the distal end of the sheath to better expose the dissection plane and maintain tension under direct visualization. Dissect the gland counterclockwise along the capsular plane until the 12 o’clock position, then continue toward the bladder neck. Incise the bladder mucosa from the 12 o’clock to 2 o’clock area to enter the bladder lumen. Then, continue cutting along the edge of the bladder neck mucosa from the 2 o’clock to 6 o’clock direction, taking care to preserve the integrity of the bladder neck. At this point, the left lobe is completely mobilized except at the junction with the middle lobe. Similarly, the middle and right lobes are gradually dissected clockwise from the 5 o’clock to 12 o’clock direction, finally converging at the 12 o’clock position. When the gland is large, after the median and right lobes have been partially dissected, the mobilized portion of the left lobe may be pushed into the bladder cavity to increase the operative space in the prostatic fossa. Alternatively, the left lobe and median lobe may be dissected and mobilized first, then pushed into the bladder cavity separately. Inspect the urethral resection margin and the prostatic cavity, trim the wound edges, and ensure thorough hemostasis. Use a tissue resection device to pulverize and aspirate the glandular tissue.  

纳入标准:

Inclusion criteria

排除标准:

1. ASA分级>3级 2. 正在接受抗感染治疗或糖皮质激素治疗的患者; 3. 基于全面的术前评估,可能存在高并发症风险的抗凝治疗患者; 4. 肾功能不全:血清肌酐(sCr)>1.5 ×正常上限(upper limit of normal, ULN); 5. 肝功能不全:AST和ALT >2.5 × ULN;总胆红素 >1.5 × ULN; 6. 既往有神经源性下尿路功能障碍; 7. 尿道狭窄患者; 8. 重度肺病、心血管病和血液病等有麻醉和手术禁忌的患者; 9. 同时参加任何其他临床研究; 10. 在研究前12月内有任何以下病症:心肌梗死、心绞痛控制不佳、冠状/外周动脉旁路移植、症状性充血性心力衰竭、脑血管意外或短暂性脑缺血发作以及持续6个月的深静脉血栓形成或肺栓塞; 11. 以前接受过膀胱出口手术; 12. 罹患具有临床意义的急性疾病; 13. 患者服用了主要研究者认为妨碍参与本试验的药物; 14. 已知的中枢神经系统或外周神经系统疾病; 15. 有任何前列腺癌临床证据的患者; 16. HIV阳性或任何其他免疫抑制病症; 17. 心理疾病/精神疾病/已知的认知障碍

Exclusion criteria:

1. ASA classification > Grade 3 2. Patients currently receiving antimicrobial therapy or glucocorticoid treatment; 3. Patients on anticoagulant therapy who, based on comprehensive preoperative assessment, may be at high risk for complications; 4. Renal impairment: Serum creatinine (sCr) >1.5 × upper limit of normal (ULN); 5. Hepatic impairment: AST and ALT >2.5 × ULN; total bilirubin >1.5 × ULN; 6. History of neurogenic lower urinary tract dysfunction; 7. Patients with urethral stricture; 8. Patients with severe pulmonary, cardiovascular, or hematologic disease contraindicating anesthesia and surgery; 9. Concurrent participation in any other clinical study; 10. Any of the following conditions within 12 months prior to study entry: myocardial infarction, poorly controlled angina pectoris, coronary/peripheral artery bypass grafting, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, and deep vein thrombosis or pulmonary embolism persisting for 6 months; 11. Previous bladder outlet surgery; 12. Suffering from clinically significant acute illness; 13. Patient taking medications deemed by the principal investigator to interfere with participation in this trial; 14. Known central nervous system or peripheral nervous system disease; 15. Patients with any clinical evidence of prostate cancer; 16. HIV-positive status or any other immunocompromising condition; 17. Psychiatric disorder/mental illness/known cognitive impairment.

研究实施时间:

Study execute time:

From 2024-12-31 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-04-19 00:00:00 To 2026-12-31 00:00:00

干预措施:

Interventions:

组别:

改良犁形电极PKEP组

样本量:

60

Group:

Modified plow-shaped electrode (PKEP) group

Sample size:

干预措施:

使用改良犁形电极PKEP进行前列腺剜除手术

干预措施代码:

Intervention:

Prostate Enucleation Using the Modified Plow-Shaped Electrode (PKEP)

Intervention code:

组别:

B-TURP组

样本量:

60

Group:

B-TURP group

Sample size:

干预措施:

使用双极经尿道前列腺电切术切除增生前列腺

干预措施代码:

Intervention:

Removal of an enlarged prostate using bipolar transurethral resection of the prostate

Intervention code:

组别:

HoLEP组

样本量:

60

Group:

HoLEP Group

Sample size:

干预措施:

使用钬激光进行前列腺剜除手术

干预措施代码:

Intervention:

Prostate enucleation using a holmium laser

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

福州大学附属省立医院 

单位级别:

三甲  

Institution
hospital:

Fuzhou University Affiliated Provincial Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

三明市第一医院 

单位级别:

三甲 

Institution
hospital:

Sanming First Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

福建省福清市医院 

单位级别:

三甲 

Institution
hospital:

Fuqing City Hospital, Fujian Province

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

福建省福鼎市医院 

单位级别:

三乙 

Institution
hospital:

Fuding City Hospital, Fujian Province

Level of the institution:

Tertiary B

测量指标:

Outcomes:

指标中文名:

平均失血量(估计失血量)

指标类型:

主要指标

Outcome:

Average blood loss (estimated blood loss)

Type:

Primary indicator

测量时间点:

术后24小时

测量方法:

1、比较术前和术后的血红蛋白浓度和血细胞比容;2、测量灌注液血红蛋白水平(血红蛋白光度计测量法);3、输血及输血量

Measure time point of outcome:

Postoperative 24 hours

Measure method:

1. Comparison of preoperative and postoperative hemoglobin concentration and hematocrit; 2. Measurement of irrigation fluid hemoglobin levels (hemoglobin spectrophotometry); 3. Blood transfusion and transfusion volume

指标中文名:

术中和术后的并发症及发生率

指标类型:

次要指标

Outcome:

Intraoperative and postoperative complications and incidence rate

Type:

Secondary indicator

测量时间点:

测量方法:

Clavien-Dindo 标准

Measure time point of outcome:

Measure method:

Clavien-Dindo classification

指标中文名:

术后留置导尿管时间

指标类型:

次要指标

Outcome:

Postoperative catheterization duration

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

住院持续时间

指标类型:

次要指标

Outcome:

Hospital length of stay

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术前和术后 PSA

指标类型:

次要指标

Outcome:

Preoperative and postoperative PSA

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术前和术后 IPSS

指标类型:

次要指标

Outcome:

Preoperative and postoperative IPSS

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

最大尿流率(Qmax)

指标类型:

次要指标

Outcome:

Maximum urinary flow rate (Qmax)

Type:

Secondary indicator

测量时间点:

术后长达 12 个月

测量方法:

Measure time point of outcome:

Up to 12 months postoperatively

Measure method:

指标中文名:

术后残余尿量(PVR)

指标类型:

次要指标

Outcome:

Postoperative residual urine volume (PVR)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

总体健康相关生活质量(SF-36、ICS、SHIM、EuroQoL)

指标类型:

次要指标

Outcome:

Overall health-related quality of life (SF-36, ICS, SHIM, EuroQoL)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

IIEF-5(勃起功能情况)

指标类型:

次要指标

Outcome:

IIEF-5 (erectile function)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

安全性指标(包括:平均失血量、输血情况、切除前列腺体积、TUR综合征、急性尿潴留、尿失禁、尿道狭窄、膀胱颈挛缩、逆行射精)

指标类型:

次要指标

Outcome:

Safety outcomes (including: average blood loss, blood transfusion status, resected prostate volume, TUR syndrome, acute urinary retention, urinary incontinence, urethral stricture, bladder neck contracture, retrograde ejaculation)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

尿液

组织:

Sample Name:

Urine

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 50 years
最大 Max age 80 years

性别:

男性

Gender:

Male

随机方法(请说明由何人用什么方法产生随机序列):

中央分层区组随机化法

Randomization Procedure (please state who generates the random number sequence and by what method):

Central stratified block randomization method

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

通过文章发表共享数据或可于研究结束后通过联系jingyw20250101@163.com以合理的要求和理由获取

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Data may be shared through the publication of the article or obtained upon reasonable request and with valid justification by contacting the jingyw20250101@163.com after the study is completed.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

数据采集由随访人员如实记录在病例记录表上,数据的管理由其它专业人员录入到电子采集和管理系统中安全储存

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection is accurately recorded by follow-up staff on case record forms, and the data is managed by other professionals who enter it into an electronic data collection and management system for secure storage.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2026-04-17 10:23:34