Heinrich Elmar, Schiefelbein Frank, Schoen Georg
Department of Urology, Missionsärztliche Klinik Würzburg, Würzburg, Germany.
Eur Urol. 2007 Dec;52(6):1632-7. doi: 10.1016/j.eururo.2007.07.033. Epub 2007 Jul 31.
Photoselective laser vaporisation prostatectomy with an 80-W potassium-titanyl-phosphate (KTP) laser is an effective procedure for men with symptomatic benign prostatic hyperplasia. The main advantages of the laser treatment are less blood loss and the short hospital stay.
The DVD and photos show the main steps and difficulties of the procedure. All patients were evaluated preoperatively and postoperatively by using the International Prostate Symptom Score, volume of prostate, maximum flow rate, haemoglobin values, and postmicturition volume of residual urine. Days of bladder catheterisation, duration of the procedure, and prostate-specific antigen values were determined as well.
The results in 140 patients, who underwent KTP laser treatment, were evaluated. The mean age of the patients was 69+/-7.8 yr. Mean volume of prostates, mean operative time, and mean energy delivery were 43+/-22 ml, 53+/-16 min, and 181+/-58 kJ, respectively. The bladder catheter was removed usually on the first postoperative day. Preoperative haemoglobin values were just slightly higher at 14.4+/-1.3g/dl compared to the postoperative values of 13.9+/-1.4 g/dl. The most common complication, dysuria, was seen in 35 patients (25%), followed by mild haematuria in 21 patients (15%).
Photoselective laser vaporisation of the prostate is a treatment option in men who are at high risk for clinically significant bleeding. The procedure provides a high level of intraoperative and postoperative safety and seems to be comparable to transurethral resection of the prostate in the relief of obstructive symptoms.
采用80瓦磷酸钛钾(KTP)激光进行光选择性前列腺汽化切除术,对于有症状的良性前列腺增生男性患者是一种有效的手术方法。激光治疗的主要优点是出血少和住院时间短。
DVD和照片展示了该手术的主要步骤和难点。所有患者术前和术后均采用国际前列腺症状评分、前列腺体积、最大尿流率、血红蛋白值以及排尿后残余尿量进行评估。还确定了膀胱导尿天数、手术持续时间以及前列腺特异性抗原值。
对140例行KTP激光治疗的患者结果进行了评估。患者的平均年龄为69±7.8岁。前列腺平均体积、平均手术时间和平均能量传递分别为43±22毫升、53±16分钟和181±58千焦。膀胱导尿管通常在术后第一天拔除。术前血红蛋白值略高于术后,分别为14.4±1.3克/分升和13.9±1.4克/分升。最常见的并发症是排尿困难,35例患者(25%)出现,其次是21例患者(15%)出现轻度血尿。
光选择性前列腺汽化术是临床上有显著出血高风险男性患者的一种治疗选择。该手术提供了高水平的术中及术后安全性,在缓解梗阻性症状方面似乎与经尿道前列腺切除术相当。