Department of Urology, Institute of Oncology, Kielce, Poland.
J Urol. 2011 Sep;186(3):873-6. doi: 10.1016/j.juro.2011.04.080. Epub 2011 Jul 23.
We evaluated the feasibilty, safety and results of extraperitoneal laparoscopic Millin prostatectomy using finger enucleation through an additional 1 cm suprapubic incision.
A total of 66 consecutive laparoscopic simple prostatectomies were performed with this technique in men with symptomatic bladder outflow obstruction and a prostate gland larger than 70 cc on transrectal ultrasound. Data such as operating time, intraoperative blood loss, transfusion rate, complications, catheterization period, hospitalization time and surgical specimen weight were prospectively collected and evaluated. Preoperative and 3-month postoperative International Prostate Symptom Score and urinary flow rates were used to assess the surgical outcome.
Average operating time was 55 minutes with a mean estimated blood loss of 200 ml. No blood transfusion was necessary, and no conversion, complications or mortality was present. The mean postoperative catheterization period was 7.3 days with a mean hospital stay of 5.2 days. Mean enucleated tissue weight was 85.5 gm. At 3 months postoperatively the International Prostate Symptom Score improved to a mean of 5.8 (from a mean preoperative score of 29.5) while maximum urine flow improved to a mean of 18.5 ml per second (from a mean preoperative rate of 5.8 ml per second).
This procedure is safe and fast with excellent functional outcomes. However, prolonged catheterization and hospitalization are still required.
我们评估了经耻骨上额外 1cm 切口行手指剜除经腹膜外腹腔镜 Millin 前列腺切除术的可行性、安全性和结果。
对 66 例行该技术腹腔镜单纯前列腺切除术的男性患者的临床资料进行前瞻性分析，这些患者均有症状性膀胱流出道梗阻，直肠超声提示前列腺大于 70cc。收集并评估了手术时间、术中出血量、输血率、并发症、置管时间、住院时间和手术标本重量等数据。术前和术后 3 个月的国际前列腺症状评分和尿流率用于评估手术效果。
平均手术时间为 55 分钟，平均估计出血量为 200ml。无需输血，无中转、并发症或死亡。术后平均留置导尿管时间为 7.3 天，平均住院时间为 5.2 天。平均剜除组织重量为 85.5 克。术后 3 个月，国际前列腺症状评分平均改善至 5.8（术前平均评分 29.5），最大尿流率平均改善至 18.5ml/秒（术前平均 5.8ml/秒）。
该手术安全、快速，具有良好的功能效果。但仍需要较长时间的置管和住院时间。
