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等离子 Kinetic™(双极)经尿道前列腺切除术:一项研究病理伪影、手术参数和临床结果的前瞻性试验。

PlasmaKinetic™ (bipolar) transurethral resection of prostate: a prospective trial to study pathological artefacts, surgical parameters and clinical outcomes.

机构信息

Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore 529889.

出版信息

Singapore Med J. 2011 May;52(5):336-9.

Abstract

INTRODUCTION

The aims of the study were to compare the degree of cautery artefacts in prostatic chips between monopolar and PlasmaKinetic™ transurethral resection of prostate (TURP), and to determine if there is any difference in the intraoperative and post surgical parameters between them.

METHODS

After institutional review board approval, patients were prospectively enrolled to undergo PlasmaKinetic™ TURP. Their parameters were compared with those of the historical monopolar TURP controls. All histological specimens were reviewed by a single senior pathologist.

RESULTS

46 patients were recruited to undergo PlasmaKinetic™ TURP. The resection time was significantly longer for the bipolar group compared to the monopolar group (50.2 versus 36.7 min, p-value is 0.001). The speed of resection (resection weight/time) was lower for the bipolar group (0.45 versus 0.56 g/min, p-value is 0.017). More irrigant was used for the bipolar group (21.2 versus 15.6 litres, p-value is 0.001) intraoperatively. There was no statistically significant difference in terms of intraoperative drop in haemoglobin and serum sodium change between the two groups. There seems to be a lesser degree of cautery artefacts in the PlasmaKinetic™ group than the monopolar group (42.17 versus 45.07 microns); however, this was not statistically significant (p-value is 0.452).

CONCLUSION

Bipolar TURP seems to result in a lesser degree of cautery artefacts when compared to conventional monopolar TURP, albeit statistically insignificant, compared to monopolar TURP. TURP also resulted in a longer resection time and increased irrigant use, but no difference in blood loss and serum sodium levels.

摘要

介绍

本研究旨在比较等离子前列腺剜除术(PKRP)与传统单极经尿道前列腺电切术(TURP)时前列腺组织焦痂形成的严重程度,并确定这两种手术方式的术中及术后参数是否存在差异。

方法

经机构审查委员会批准,前瞻性纳入接受 PKRP 的患者,将其参数与历史上的单极 TURP 对照组进行比较。所有组织学标本均由一名资深病理学家进行审阅。

结果

共招募了 46 例患者接受 PKRP。与单极组相比,双极组的切除时间明显更长(50.2 分钟对 36.7 分钟,p 值为 0.001)。双极组的切除速度(切除重量/时间)较低(0.45 克/分钟对 0.56 克/分钟,p 值为 0.017)。术中双极组使用的灌洗液更多(21.2 升对 15.6 升,p 值为 0.001)。两组术中血红蛋白下降和血清钠变化无统计学差异。PKRP 组的焦痂形成程度似乎比单极组小(42.17 微米对 45.07 微米);但差异无统计学意义(p 值为 0.452)。

结论

与传统单极 TURP 相比,双极 TURP 似乎导致焦痂形成程度较轻,但与单极 TURP 相比,差异无统计学意义。TURP 还导致切除时间延长和灌洗液用量增加,但术中出血量和血清钠水平无差异。

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