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双极经尿道前列腺剜除术及切除术的术后早期结果

Early postoperative outcome of bipolar transurethral enucleation and resection of the prostate.

作者信息

Cho C L, Leung Clarence L H, Chan Wayne K W, Chu Ringo W H, Law I C

机构信息

Division of Urology, Department of Surgery, Kwong Wah Hospital, Yaumatei, Hong Kong.

出版信息

Hong Kong Med J. 2015 Dec;21(6):528-35. doi: 10.12809/hkmj144457. Epub 2015 Oct 16.

Abstract

OBJECTIVES

To report the early postoperative outcome of bipolar transurethral enucleation and resection of the prostate. Our results were compared with those published from various centres.

SETTING

Regional hospital, Hong Kong.

PATIENTS

A total of 28 consecutive patients who had undergone bipolar transurethral enucleation and resection of the prostate by a single surgeon between January and June 2014. All patients were evaluated preoperatively by physical examination, digital rectal examination, transrectal ultrasonography, and laboratory studies, including measurement of haemoglobin, sodium, and prostate-specific antigen levels. Patients were assessed perioperatively and at 4 weeks and 3 months postoperatively.

RESULTS

The mean resected specimen weight of prostatic adenoma in 28 patients was 48.2 g with a mean enucleation and resection time of 13.6 and 47.7 minutes, respectively. There was a mean decrease in serum prostate-specific antigen by 85.9% (from 6.4 ng/mL to 0.9 ng/mL) postoperatively. Prostate volume was decreased by 68.2% (from 71.9 cm(3) to 22.9 cm(3)) at 4 weeks postoperatively. The mean postoperative haemoglobin drop was 11.5 g/L. The rate of transient urinary incontinence at 3 months was 3.6%. Patients who underwent bipolar transurethral enucleation and resection of the prostate had a short catheterisation time and hospital stay, which is comparable to conventional transurethral resection of the prostate.

CONCLUSIONS

Bipolar transurethral enucleation and resection of the prostate should become the endourological equivalent to open adenomectomy with fewer complications and short convalescence. The technique of bipolar transurethral enucleation and resection of the prostate can be acquired safely with a relatively short learning curve.

摘要

目的

报告双极经尿道前列腺剜除术及切除术的术后早期结果。将我们的结果与各中心发表的结果进行比较。

地点

香港地区医院

患者

2014年1月至6月期间,由一名外科医生连续为28例患者实施双极经尿道前列腺剜除术及切除术。所有患者术前均通过体格检查、直肠指检、经直肠超声检查及实验室检查进行评估,包括血红蛋白、钠及前列腺特异性抗原水平测定。对患者进行围手术期及术后4周和3个月的评估。

结果

28例患者前列腺腺瘤切除标本的平均重量为48.2g,剜除及切除的平均时间分别为13.6分钟和47.7分钟。术后血清前列腺特异性抗原平均下降85.9%(从6.4ng/mL降至0.9ng/mL)。术后4周前列腺体积减少68.2%(从71.9cm³降至22.9cm³)。术后血红蛋白平均下降11.5g/L。3个月时短暂性尿失禁发生率为3.6%。接受双极经尿道前列腺剜除术及切除术的患者导尿时间及住院时间较短,与传统经尿道前列腺切除术相当。

结论

双极经尿道前列腺剜除术及切除术应成为腔内泌尿外科手术中相当于开放性腺瘤切除术的术式,并发症更少,康复期更短。双极经尿道前列腺剜除术及切除术技术可安全掌握,学习曲线相对较短。

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