Richter Torsten, Huebler Matthias
Department of Anesthesia and Intensive Care, Carl Gustav Carus University Hospital, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
BMC Anesthesiol. 2014 May 12;14:32. doi: 10.1186/1471-2253-14-32. eCollection 2014.
In 1996, Holmium laser enucleation of the prostate was introduced and has been shown to be safe and highly effective.
We report a case of a rare complication that resulted in intra-abdominal compartment syndrome with prolonged intubation and intensive care, involving an 74-year-old male after holmium laser enucleation of prostate, with a massive irrigant fluid leakage into the retroperitoneal space. The elevated abdominal pressure was reduced by forced diuresis. The tracheal tube was removed 18 hours after the patient's transfer to the ICU. The patient was discharged to home one week after the operation.
In rare cases when no obvious ruptures of the prostate capsule or the bladder occur during laser enucleation of prostate, knowledge regarding possible emersion of massive amounts of irrigant fluid into the retroperitoneal space leading to intra-abdominal compartment syndrome aids in the diagnosis and subsequent successful therapy of intra-abdominal hypertension.
1996年，钬激光前列腺剜除术被引入，已证明其安全且高效。
我们报告一例罕见并发症，该并发症导致腹腔间隔室综合征，需长时间插管和重症监护，患者为一名74岁男性，在钬激光前列腺剜除术后出现大量冲洗液漏入腹膜后间隙。通过强制利尿降低了升高的腹压。患者转入重症监护病房18小时后拔除气管导管。术后一周患者出院回家。
在前列腺激光剜除术中，若未发生前列腺包膜或膀胱明显破裂的罕见情况下，了解大量冲洗液可能渗入腹膜后间隙导致腹腔间隔室综合征，有助于诊断及随后成功治疗腹腔高压。
