Qu Lijun, Wang Xinghuan, Huang Xing, Zhang Yanqing, Zeng Xiao
Second Clinic College of Wuhan University, Wuhan, China.
Urology. 2007 Nov;70(5):1034-8. doi: 10.1016/j.urology.2007.09.015.
To compare the hemostatic properties of transurethral plasmakinetic resection of the prostate (PKRP), transurethral vaporization resection of the prostate (TUVRP) and transurethral resection of the prostate (TURP) ex vivo, as perioperative bleeding is still regarded as one of major complications of transurethral prostatectomy.
The modified model of isolated normal saline (NS)-perfused porcine kidney was used to determine the hemostatic efficacy of PKRP, TUVRP, and TURP. The loss of normal saline was semiquantitatively measured in relation to tissue ablation for the 3 techniques and specimens were evaluated histologically.
The median values of NS loss rate of PKRP, TUVRP, and TURP were 4.02, 3.74, and 6.51 mL/min, respectively. The NS loss rate of TUVRP and PKRP were obviously lower than that of TURP (P <0.05). The difference between the NS loss rate of PKRP and TUVRP was not significant (P >0.05). The median values of depths of the coagulation zones of PKRP, TUVRP, and TURP were 217, 292, and 140 microm, respectively. Coagulation depth with TURP was significantly smaller than that with TUVRP and PKRP (P <0.05). Coagulation depth with PKRP was also smaller than that with TUVRP (P <0.05).
PKRP is comparable with TUVRP in hemostasis and both of them could cause significantly less perioperative bleeding than TURP.
由于围手术期出血仍被视为经尿道前列腺切除术的主要并发症之一，因此在体外比较经尿道前列腺等离子双极电切术（PKRP）、经尿道前列腺汽化电切术（TUVRP）和经尿道前列腺电切术（TURP）的止血特性。
采用改良的离体生理盐水灌注猪肾模型来测定PKRP、TUVRP和TURP的止血效果。针对这三种技术，半定量测量与组织切除相关的生理盐水损失量，并对标本进行组织学评估。
PKRP、TUVRP和TURP的生理盐水损失率中位数分别为4.02、3.74和6.51 mL/分钟。TUVRP和PKRP的生理盐水损失率明显低于TURP（P<0.05）。PKRP和TUVRP的生理盐水损失率之间差异不显著（P>0.05）。PKRP、TUVRP和TURP的凝固带深度中位数分别为217、292和140微米。TURP的凝固深度明显小于TUVRP和PKRP（P<0.05）。PKRP的凝固深度也小于TUVRP（P<0.05）。
PKRP在止血方面与TUVRP相当，且两者引起的围手术期出血均明显少于TURP。
