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经尿道钬激光前列腺剜除术治疗良性前列腺增生症

[Transurethral holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia].

作者信息

Wu Zhong, Ding Qiang, Jiang Hao-wen, Chen Zhi-xin, Zhang Hua-wei, Li Chun-jun, Zhang Yuan-fan

机构信息

Department of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Sep 26;86(36):2560-2.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of transurethral holmium laser enucleation of the prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH).

METHODS

A retrospective review was conducted of transurethral (HoLEP) performed on 68 patients, aged 65.7 (50 - 91) with benign prostatic hyperplasia. The efficacy and complications were all assessed.

RESULTS

The mean procedure time was 87 mins (45 - 158 mins). The mean specimen weight was 61 g (31 - 128 g). The procedure allows a precise, bloodless field with no need for transfusion. No TUR syndrome and other major complications were encountered during the operation. The mean catheter time and hospital stay were 2.8 d (1 - 4 d) and 3.6 d (2 - 5 d), respectively. Follow-up of 7.6 months (1 - 13 months) revealed that the urination symptoms were markedly improved in all patients, and that the IPSS decreased from 25.7 +/- 6.9 to 7.7 +/- 4.3 (P < 0.01) and the maximum urine flow rate increased from 8.1 +/- 4.2 ml/s to 18.8 +/- 4.6 ml/s (P < 0.01). Postoperative complications occurred in 3 patients. 2 with transient incontinence were recovered within 3 months postoperatively. The other one with mild posterior urethral stricture was treated effectively with urethral sounding.

CONCLUSIONS

Was associated with high effectiveness, safety, short hospital stay and less complications, HoLEP is a new minimally invasive surgical procedure for BPH.

摘要

目的

评估经尿道钬激光前列腺剜除术(HoLEP)治疗良性前列腺增生(BPH)的疗效和安全性。

方法

对68例年龄为65.7岁(50 - 91岁)的良性前列腺增生患者行HoLEP手术进行回顾性分析。评估手术疗效及并发症。

结果

平均手术时间为87分钟(45 - 158分钟)。平均标本重量为61克(31 - 128克)。该手术可提供精确的无血视野,无需输血。术中未发生经尿道电切综合征及其他严重并发症。平均导尿管留置时间和住院时间分别为2.8天(1 - 4天)和3.6天(2 - 5天)。7.6个月(1 - 13个月)的随访结果显示,所有患者排尿症状均明显改善,国际前列腺症状评分(IPSS)从25.7±6.9降至7.7±4.3(P < 0.01),最大尿流率从8.1±4.2毫升/秒增至18.8±4.6毫升/秒(P < 0.01)。3例患者出现术后并发症。2例短暂性尿失禁患者在术后3个月内恢复。另1例轻度后尿道狭窄患者经尿道探条扩张治疗有效。

结论

HoLEP疗效高、安全性好、住院时间短且并发症少,是一种治疗BPH的新型微创手术方法。

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