Department of Urology, Second Affiliated Hospital of Soochow University, Suzhou, China.
Lasers Med Sci. 2013 Jul;28(4):1151-7. doi: 10.1007/s10103-012-1212-2. Epub 2012 Oct 4.
The purpose of this study is to evaluate the safety and efficacy of 120-W potassium titanyl phosphate (KTP) laser vaporization in patients with benign prostatic hyperplasia (BPH) who also had cardiopulmonary diseases who were taking long-term anticoagulants and were at high risk of bleeding complications. The prospective study included 188 patients with severe lower urinary tract symptoms who underwent 120-W KTP laser vaporization of the prostate. All patients were at high cardiopulmonary risk, having presented with an American Society of Anesthesiology score of 3 or greater. Of those, 45 patients were taking oral anticoagulants, and 1 had a severe bleeding disorder. BPH was successfully treated with 120-W KTP laser vaporization in all patients. Mean preoperative prostate volume ± SD was 66 ± 23.1 ml, and mean operative time was 50.8 ± 15.5 min. There were no major complications intraoperatively or postoperatively, and no blood transfusions were required. Postoperatively, only 14 patients (7.4 %) required bladder irrigation. Average catheterization time was 1.9 ± 1.5 days (range, 1-5 days). Three patients required reoperation due to enlarged prostates from residual adenoma. At 3-, 6,- 12-, and 24-month follow-ups, mean urinary peak flow increased from 8.0 ± 3.6 ml/s to 19.1 ± 5.6, 19.2 ± 4.7, 19.1 ± 4.65, and 19.2 ± 4.34 ml/s, respectively. Mean International Prostate Symptom Scores decreased over time, from 25.6 ± 5.1 (3 months) to 9.4 ± 2.8, 7.05 ± 1.46, 6.24 ± 1.36, and 6.20 ± 1.32 (24 months), respectively. 120-W HPS KTP laser vaporization is a safe and effective treatment option in BPH patients at high risk and those on anticoagulation therapy who have severe LUTS secondary to BPH.
本研究旨在评估 120-W 钾钛磷酸（KTP）激光前列腺汽化术在合并心肺疾病、长期服用抗凝药物且存在出血并发症高危风险的良性前列腺增生（BPH）患者中的安全性和有效性。该前瞻性研究纳入了 188 例因严重下尿路症状而接受 120-W KTP 激光前列腺汽化术的患者。所有患者心肺风险较高，美国麻醉医师协会评分均为 3 分或更高。其中，45 例患者服用口服抗凝药物，1 例患者存在严重出血性疾病。所有患者均成功地接受了 120-W KTP 激光前列腺汽化术治疗。术前前列腺体积的平均值±标准差为 66±23.1ml，手术时间平均为 50.8±15.5min。术中及术后均无重大并发症发生，也无需输血。术后仅 14 例（7.4%）患者需要膀胱冲洗。平均导尿管留置时间为 1.9±1.5 天（1-5 天）。由于残留腺瘤，3 例患者因前列腺增大而需要再次手术。在 3、6、12 和 24 个月的随访中，平均尿流率从 8.0±3.6ml/s 增加到 19.1±5.6、19.2±4.7、19.1±4.65 和 19.2±4.34ml/s。国际前列腺症状评分（IPSS）随时间逐渐降低，从 25.6±5.1（3 个月）降至 9.4±2.8、7.05±1.46、6.24±1.36 和 6.20±1.32（24 个月）。对于存在严重 BPH 所致下尿路症状且合并心肺疾病、长期服用抗凝药物且存在出血并发症高危风险的 BPH 患者，120-W HPS KTP 激光前列腺汽化术是一种安全且有效的治疗选择。
