Liao Guo-Dong, Shen Zhou-Jun, Zhou Xie-Lai, Chen Shan-Wen, Chen Jun, Wang Shuo, Shi Shi-Fang, Zhang Zhi-Gen, Cai Song-Liang
Department of Urology, First Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
Zhonghua Nan Ke Xue. 2007 Jul;13(7):613-6.
To evaluate the factors for the conversion of transurethral resection of the prostate (TURP) to open prostatectomy and to provide clinical evidence for surgical options.
From January 1997 to March 2005, we performed 1 086 TURP and made retrospective analyses of 11 risk factors concerning the demographics, clinical history, laboratory data, ultrasound results, and intraoperative complications of the patients. In addition, multivariate logistic regression was used to determine those variables predicting the conversion of TURP.
Thirty-nine (3.59%) of the TURP cases required conversion, mostly because of uncontrollable hemorrhage (71.79%). Multivariate analyses showed that a prostate volume > 85.2 ml (OR = 2.568, P < 0.01), intraoperative slit of capsula prostatic (OR = 1.916, P < 0.01) and a second midstream bladder specimen (VB2) white blood cell count of the urine > 13.5/HP (OR = 1.486, P < 0.01) predicted the conversion to open prostatectomy.
Benign prostatic hyperplasia (BPH) patients with a huge prostate and those with intraoperative slit of capsula prostatic undergoing TURP are more likely to be converted. And uncontrollable hemorrhage, huge prostate and poor endoscopic vision are the major reasons for the conversion.
评估经尿道前列腺电切术（TURP）转为开放性前列腺切除术的相关因素，为手术选择提供临床依据。
1997年1月至2005年3月，我们共进行了1086例TURP手术，并对患者的人口统计学、临床病史、实验室数据、超声检查结果及术中并发症等11项危险因素进行回顾性分析。此外，采用多因素logistic回归分析确定预测TURP转为开放性手术的变量。
39例（3.59%）TURP手术需要转为开放性手术，主要原因是出血难以控制（71.79%）。多因素分析显示，前列腺体积>85.2ml（OR=2.568，P<0.01）、术中前列腺包膜裂开（OR=1.916，P<0.01）以及第二次膀胱中段尿标本（VB2）白细胞计数>13.5/HP（OR=1.486，P<0.01）可预测转为开放性前列腺切除术。
前列腺体积巨大的良性前列腺增生（BPH）患者以及术中发生前列腺包膜裂开的患者接受TURP手术时更有可能转为开放性手术。出血难以控制、前列腺体积巨大和内镜视野不佳是转为开放性手术的主要原因。
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