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经尿道双极前列腺剜除术联合前列腺切除术治疗有症状良性前列腺增生症的学习曲线:连续100例患者的经验

Learning curve for bipolar transurethral enucleation and resection of the prostate in saline for symptomatic benign prostatic hyperplasia: experience in the first 100 consecutive patients.

作者信息

Xiong Wei, Sun Minghan, Ran Qing, Chen Fang, Du Yangchun, Dou Ke

机构信息

Division of Urology and Transplantation, Department of Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, PR China. xiongweimd @ gmail.com

出版信息

Urol Int. 2013;90(1):68-74. doi: 10.1159/000343235. Epub 2012 Nov 7.

Abstract

BACKGROUND

Bipolar transurethral enucleation and resection of the prostate in saline has recently been considered as a safe and technically feasible endoscopic procedure for symptomatic benign prostatic hyperplasia. However, it has not been accepted widely because of the perception of technical difficulty.

METHODS

A retrospective data review was performed of the first consecutive 100 patients who had undergone bipolar transurethral enucleation and resection of prostatic adenoma. Operative outcome, complications, ratio of conversion to conventional transurethral resection of the prostate and efficiency of tissue enucleation and resection were used to assess the learning curve.

RESULTS

Bipolar transurethral enucleation and resection of the prostate was successfully performed in 83 patients. The mean operative time was 117.5 min, and the mean indwelling catheterization was 3.3 ± 1.9 days. After 6 months, maximum urinary flow was 21.34 ± 4.09 ml/s, IPSS was 9.66 ± 2.64, and quality of life was 2.31 ± 0.92 with a residual prostate volume of 35.29 ± 17.57 ml. Regarding the learning curve, the ratio of conversion to conventional bipolar transurethral resection of the prostate decreased after 30 cases, and the efficiency of enucleation and resection increased significantly with accumulative experience after 50 cases.

CONCLUSIONS

The current results established that bipolar transurethral enucleation and resection of the prostate in saline is a safe and reproducible procedure.

摘要

背景

双极经尿道前列腺腺瘤剜除术及在生理盐水中的前列腺切除术最近被认为是一种治疗有症状良性前列腺增生的安全且技术上可行的内镜手术。然而,由于其技术难度的观念,该手术尚未被广泛接受。

方法

对连续接受双极经尿道前列腺腺瘤剜除术及切除术的首批100例患者进行回顾性数据审查。手术结果、并发症、转为传统经尿道前列腺切除术的比例以及组织剜除和切除的效率用于评估学习曲线。

结果

83例患者成功进行了双极经尿道前列腺剜除术及切除术。平均手术时间为117.5分钟,平均留置导尿时间为3.3±1.9天。6个月后,最大尿流率为21.34±4.09毫升/秒,国际前列腺症状评分(IPSS)为9.66±2.64,生活质量评分为2.31±0.92,残余前列腺体积为35.29±17.57毫升。关于学习曲线,30例手术后转为传统双极经尿道前列腺切除术的比例下降,50例手术后随着累积经验的增加,剜除和切除的效率显著提高。

结论

目前的结果表明,双极经尿道前列腺腺瘤剜除术及在生理盐水中的前列腺切除术是一种安全且可重复的手术。

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