Bhansali Manish, Patankar Suresh, Dobhada Sayten, Khaladkar Suparn
AMAI Trust's Institute of Urology, Pune, India.
J Endourol. 2009 Jan;23(1):141-5. doi: 10.1089/end.2007.0005.
Today, urologists around the world are encountering greater numbers of larger prostate glands, probably because of an initial trial of pharmacotherapy. The present study was performed to assess the safety and efficacy of bipolar transurethral resection of large prostate glands using the PlasmaKinetic (PK) Superpulse System.
This single-blind, randomized study included 70 patients with prostate gland >60 g seen on three-dimensional transrectal ultrasonography. Patients were randomized 1:1 using envelopes into either a PK Superpulse transurethral resection of the prostate (TURP) group or conventional TURP group, and underwent the procedure accordingly. Perioperative and postoperative parameters included operative time, blood loss, need for blood transfusion, clinical transurethral resection (TUR) syndrome, and duration of catheterization and hospitalization. Of 70 patients, 67 were followed for a minimum of 9 months, and data were analyzed using SPSS software.
Both groups were comparable in terms of preoperative parameters, which included American Urological Association Symptom Score, Qmax, gland size, and postvoid residual. A statistically significant difference between the two groups was found in terms of perioperative blood loss, change in serum sodium, and duration of catheterization. These complications were significantly less in the PK Superpulse group, with an obvious reduction in the duration of hospitalization in that group.
The PK Superpulse System can be used as safely and effectively in the resection of the large gland (>60 g) as it has been reported to be in the resection of small and medium-sized glands. By using physiologic saline (0.9% NaCl) as irrigation fluid, it eliminates any danger of TUR syndrome and thus eliminates the conventional time limit of resection. PK Superpulse TURP is a promising treatment modality in the management of large prostate glands. It has all the features of gold-standard monopolar TURP, along with added safety and efficacy. It is ready to be included in the urologist's armamentarium.
如今，全球泌尿外科医生遇到的前列腺体积较大的患者数量增多，这可能是因为最初采用了药物治疗。本研究旨在评估使用等离子动态（PK）超脉冲系统进行双极经尿道大前列腺切除术的安全性和有效性。
这项单盲随机研究纳入了70例经三维经直肠超声检查前列腺体积>60 g的患者。使用信封法将患者按1:1随机分为PK超脉冲经尿道前列腺切除术（TURP）组或传统TURP组，并相应地接受手术。围手术期和术后参数包括手术时间、失血量、输血需求、临床经尿道切除术（TUR）综合征以及导尿和住院时间。70例患者中，67例至少随访了9个月，并使用SPSS软件进行数据分析。
两组在术前参数方面具有可比性，术前参数包括美国泌尿外科学会症状评分、最大尿流率、腺体大小和残余尿量。两组在围手术期失血量、血清钠变化和导尿时间方面存在统计学显著差异。PK超脉冲组的这些并发症明显更少，该组住院时间明显缩短。
PK超脉冲系统在大腺体（>60 g）切除术中的使用与在中小腺体切除术中一样安全有效。通过使用生理盐水（0.9% NaCl）作为冲洗液，它消除了TUR综合征的任何风险，从而消除了传统的切除时间限制。PK超脉冲TURP是治疗大前列腺的一种有前景的治疗方式。它具有金标准单极TURP的所有特征，同时增加了安全性和有效性。它已准备好纳入泌尿外科医生的治疗手段。
