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[经尿道在生理盐溶液中切除膀胱肿瘤及前列腺增生(TURIS)。一项前瞻性研究]

[Transurethral resection of bladder tumors and prostate enlargement in physiological saline solution (TURIS). A prospective study].

作者信息

Rose A, Suttor S, Goebell P J, Rossi R, Rübben H

机构信息

Urologische Klinik, Universitätsklinikum, Hufelandstrasse 55, 45122 Essen.

出版信息

Urologe A. 2007 Sep;46(9):1148-50. doi: 10.1007/s00120-007-1391-9.

Abstract

BACKGROUND

Transurethral resection in a conductive irrigant medium is a new procedure in the surgical therapy of bladder tumors and prostate enlargement. In this prospective randomized trial we compared conventional TUR with TUR in saline regarding safety and efficiency.

PATIENTS AND METHODS

Between November 2004 and February 2005 a total number of 128 patients were included in this study. After randomization 58 patients were treated by conventional TUR and 70 patients by TURIS (Olympus, SurgMasterSystem). We evaluated resection time, weight of resected tissue, complications, blood loss, changes in serum sodium, and duration of catheterization.

RESULTS

Among the tested procedures no statistically significant difference could be observed concerning blood loss, change of serum sodium, and complications. The mean weight of resected tissue of the prostate per time was 0.9 g/min with the TUR procedure and 0.8 g/min with the TURIS procedure. Severe complications like TUR syndrome or perforation of the bladder were not observed at all. In the TURIS group time until catheter removal was longer but also the mean weight of resected tissue of the prostate was higher in the TURIS group (42 g) than in the conventional TUR group (31 g).

CONCLUSIONS

Transurethral resection in a conductive irrigant medium (TURIS) can be considered as a safe and effective surgical procedure in the treatment of BPH and superficial urothelial carcinoma. Moreover the risk of TUR syndrome and perforation of the bladder due to nerve stimulation is reduced.

摘要

背景

在导电灌洗介质中进行经尿道切除术是膀胱肿瘤和前列腺增生手术治疗中的一种新方法。在这项前瞻性随机试验中,我们比较了传统经尿道切除术(TUR)和在生理盐水中进行的经尿道切除术(TURIS)在安全性和效率方面的差异。

患者与方法

2004年11月至2005年2月期间,共有128例患者纳入本研究。随机分组后,58例患者接受传统TUR治疗,70例患者接受TURIS(奥林巴斯,SurgMasterSystem)治疗。我们评估了切除时间、切除组织重量、并发症、失血量、血清钠变化以及导尿时间。

结果

在所测试的手术方法中,在失血量、血清钠变化和并发症方面未观察到统计学上的显著差异。TUR手术每次切除前列腺组织的平均重量为0.9克/分钟,TURIS手术为0.8克/分钟。完全未观察到诸如TUR综合征或膀胱穿孔等严重并发症。在TURIS组中,拔除导尿管的时间较长,但TURIS组切除的前列腺组织平均重量(42克)也高于传统TUR组(31克)。

结论

在导电灌洗介质中进行经尿道切除术(TURIS)可被视为治疗良性前列腺增生(BPH)和浅表性尿路上皮癌的一种安全有效的手术方法。此外,因神经刺激导致的TUR综合征和膀胱穿孔的风险降低。

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