Porpiglia F, Tarabuzzi R, Cossu M, Vacca F, Destefanis P, Fiori C, Scarpa R M
Divisione Universitaria di Urologia, Dipartimento di Scienze Cliniche e Biologiche, Azienda Ospedaliera S. Luigi, Orbassano, Torino, Italy.
Urology. 2002 Dec;60(6):1045-9. doi: 10.1016/s0090-4295(02)01985-4.
To compare our experience with transurethral resection of the prostate and sequential laparoscopic bladder diverticulectomy with a previous series of combined open bladder diverticulectomy and transvesical prostatectomy.
We compared the data of 10 consecutive patients (group 1) who underwent sequential transurethral resection of the prostate and transperitoneal laparoscopic bladder diverticulectomy and 13 consecutive patients (group 2) who underwent traditional combined open bladder diverticulectomy and transvesical prostatectomy. The following parameters were considered: size and position of the diverticulum, transrectal ultrasound adenoma volume, operative time, postoperative hemoglobin variations, analgesic requirement, complications, postoperative hospital stay, and urinary flowmetry.
No statistically significant differences existed between the two groups either for diverticulum size (6.8 versus 7.2 cm) or diverticula position. A significant difference was observed in the operative time (247 minutes for group 1 versus 136 minutes for group 2, P <0.0001), mean postoperative hemoglobin decrease (2.6 g/dL for group 1 and 3.9 g/dL for group 2, P = 0.001), analgesic requirement (1.3 ampoules of buprenorphine cloritrate for group 1 versus 1.8 ampoules for group 2, P = 0.45), and postoperative hospital stay (3 days for group 1 versus 9.6 days for group 2, P <0.0001). No statistically significant difference was recorded for control flowmetry. No intraoperative complications were recorded for the two groups.
In our series, sequential transurethral resection of the prostate and transperitoneal laparoscopic diverticulectomy for large diverticula proved to be a safe, effective, and minimally invasive procedure, despite the longer operative times compared with transvesical prostatectomy and open bladder diverticulectomy.
将我们经尿道前列腺切除术及序贯性腹腔镜膀胱憩室切除术的经验与先前一组开放性膀胱憩室切除术联合经膀胱前列腺切除术的经验进行比较。
我们比较了10例连续接受经尿道前列腺切除术及经腹腹腔镜膀胱憩室切除术患者（第1组）和13例连续接受传统开放性膀胱憩室切除术联合经膀胱前列腺切除术患者（第2组）的数据。考虑了以下参数：憩室的大小和位置、经直肠超声腺瘤体积、手术时间、术后血红蛋白变化、镇痛需求、并发症、术后住院时间及尿流率测定。
两组在憩室大小（6.8对7.2 cm）或憩室位置方面均无统计学显著差异。在手术时间（第1组247分钟对第2组136分钟，P<0.0001）、术后平均血红蛋白下降量（第1组2.6 g/dL对第2组3.9 g/dL，P = 0.001）、镇痛需求（第1组1.3支氯诺昔康对第2组1.8支，P = 0.45）及术后住院时间（第1组3天对第2组9.6天，P<0.0001）方面观察到显著差异。尿流率测定无统计学显著差异。两组均未记录到术中并发症。
在我们的系列研究中，对于较大憩室，经尿道前列腺切除术及经腹腹腔镜憩室切除术序贯进行被证明是一种安全、有效且微创的手术，尽管与经膀胱前列腺切除术及开放性膀胱憩室切除术相比手术时间更长。
