Cury José, Coelho Rafael Ferreira, Bruschini Homero, Srougi Miguel
Department of Urology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2008 Jun;63(3):315-20. doi: 10.1590/s1807-59322008000300005.
To evaluate the influence of the urologist's experience on the surgical results and complications of transurethral resection of the prostate (TURP).
Sixty-seven patients undergoing transurethral resection of the prostate without the use of a video camera were randomly allocated into three groups according to the urologist's experience: a urologist having done 25 transurethral resections of the prostate (Group I - 24 patients); a urologist having done 50 transurethral resections of the prostate (Group II - 24 patients); a senior urologist with vast transurethral resection of the prostate experience (Group III - 19 patients). The following were recorded: the weight of resected tissue, the duration of the resection procedure, the volume of irrigation used, the amount of irrigation absorbed and the hemoglobin and sodium levels in the serum during the procedure.
There were no differences between the groups in the amount of irrigation fluid used per operation, the amount of irrigation fluid absorbed or hematocrit and hemoglobin variation during the procedure. The weight of resected tissue per minute was approximately four times higher in group III than in groups I and II. The mean absorbed irrigation fluid was similar between the groups, with no statistical difference between them (p=0.24). Four patients (6%) presented with TUR syndrome, without a significant difference between the groups.
The senior urologist was capable of resecting four times more tissue per time unit than the more inexperienced surgeons. Therefore, a surgeon's experience may be important to reduce the risk of secondary TURP due to recurring adenomas or adenomas that were incompletely resected. However, the incidence of complications was the same between the three groups.
评估泌尿外科医生的经验对经尿道前列腺电切术（TURP）手术结果及并发症的影响。
67例未使用摄像机行经尿道前列腺电切术的患者，根据泌尿外科医生的经验随机分为三组：完成25例经尿道前列腺电切术的泌尿外科医生（第一组 - 24例患者）；完成50例经尿道前列腺电切术的泌尿外科医生（第二组 - 24例患者）；有丰富经尿道前列腺电切术经验的资深泌尿外科医生（第三组 - 19例患者）。记录以下指标：切除组织的重量、手术时间、冲洗液用量、冲洗液吸收量以及术中血清血红蛋白和钠水平。
三组之间每次手术的冲洗液用量、冲洗液吸收量或术中血细胞比容和血红蛋白变化无差异。第三组每分钟切除组织的重量比第一组和第二组高约四倍。各组平均吸收的冲洗液相似，组间无统计学差异（p = 0.24）。4例患者（6%）出现TUR综合征，组间无显著差异。
资深泌尿外科医生每单位时间切除的组织量比经验较少的外科医生多四倍。因此，外科医生的经验对于降低因复发性腺瘤或未完全切除的腺瘤导致二次TURP的风险可能很重要。然而，三组之间并发症的发生率相同。
