Carmignani Luca, Macchi Alberto, Ratti Dario, Finkelberg Elisabetta, Casellato Stefano, Maruccia Serena, Marenghi Carlo, Picozzi Stefano Carlo Maria
Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
Korean J Urol. 2015 May;56(5):365-9. doi: 10.4111/kju.2015.56.5.365. Epub 2015 May 4.
Various articles have previously addressed the introduction of new surgical laser therapies for an enlarged prostate gland causing obstructive symptoms. The objective of this study was to report the feasibility of performing the thulium laser vapo-enucleation of the prostate (ThuVEP) procedure for benign prostatic obstruction in a 1-day surgery.
From September 2011 to September 2013, we conducted a prospective study on patients who underwent ThuVEP in a 1-day surgery. The primary outcomes measured perioperatively included operative time, resected tissue weight, hemoglobin decrease, transfusion rate, postoperative irrigation and catheterization time, and postoperative hospital stay. Also, the preoperative and postoperative International Prostate Symptom Score (IPSS) and results of uroflowmetry performed on the 7th and 30th postoperative days were recorded. All perioperative and postoperative complications were monitored.
A total of 53 patients underwent the surgical treatment in a 1-day surgery. Seven patients continued antiaggregant therapy with aspirin. Mean preoperative prostatic adenoma volume was 56.6 mL. Mean operative time was 71 minutes. The average catheter time was 14.8 hours. The peak urinary flow rate on day 7 improved from 9.3 to 17.42 mL/s (p<0.001) and the IPSS improved from 18 to 10.2 (p<0.01). Patients were routinely discharged on the day of catheter removal. No complications were recorded.
ThuVEP can be safely conducted as a 1-day surgical procedure. This strategy results in cost savings. ThuVEP shows good standardized outcomes with respect to improvement in flow parameters and length of bladder catheterization.
此前已有多篇文章论述了针对引起梗阻症状的前列腺增生引入新的外科激光治疗方法。本研究的目的是报告在日间手术中对良性前列腺梗阻患者实施铥激光前列腺汽化剜除术（ThuVEP）的可行性。
2011年9月至2013年9月，我们对在日间手术中接受ThuVEP的患者进行了一项前瞻性研究。围手术期测量的主要结果包括手术时间、切除组织重量、血红蛋白下降情况、输血率、术后冲洗及导尿时间以及术后住院时间。此外，记录术前和术后的国际前列腺症状评分（IPSS）以及术后第7天和第30天进行的尿流率测定结果。监测所有围手术期和术后并发症。
共有53例患者在日间手术中接受了手术治疗。7例患者继续使用阿司匹林进行抗血小板治疗。术前前列腺腺瘤平均体积为56.6 mL。平均手术时间为71分钟。平均导尿时间为14.8小时。术后第7天的最大尿流率从9.3 mL/s提高到17.42 mL/s（p<0.001），IPSS从18改善到10.2（p<0.01）。患者在拔除导尿管当天常规出院。未记录到并发症。
ThuVEP可作为日间手术安全实施。该策略可节省成本。ThuVEP在改善尿流参数和膀胱导尿时间方面显示出良好的标准化结果。
