Kim Yeon Joo, Lee Yoon Hyung, Kwon Joon Beom, Cho Sung Ryong, Kim Jae Soo
Department of Urology, Daegu Fatima Hospital, Daegu, Korea.
Korean J Urol. 2015 Nov;56(11):769-74. doi: 10.4111/kju.2015.56.11.769. Epub 2015 Nov 3.
The thulium laser is the most recently introduced technology for the surgical treatment of benign prostatic hyperplasia (BPH). Until recently, most thulium laser enucleation of the prostate (ThuLEP) was performed by use of the three-lobe technique. We introduce a novel one-lobe enucleation technique for ThuLEP called the "All-in-One" technique. We report our initial experiences here.
From June 2013 to May 2014, a total of 47 patients underwent the All-in-One technique of ThuLEP for symptomatic BPH performed by a single surgeon. All patients were assessed with the International Prostate Symptom Score (IPSS), transrectal ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR) before and 1 month after surgery. We reassessed IPSS, Qmax, and PVR 3 months after surgery. To assess the efficacy of the All-in-One technique, we checked the PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate.
The mean operative time was 82.1±33.3 minutes. The mean enucleation time and morcellation time were 52.7±21.7 minutes and 8.2±7.0 minutes, respectively. The mean resected tissue weight and decrease in hemoglobin were 36.9±24.6 g and 0.4±0.8 g/dL, respectively. All perioperative parameters showed significant improvement (p<0.05). No major complications were observed. The PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate were 0.81, 0.92, and 4.3%, respectively.
The All-in-One technique of ThuLEP showed efficacy and effectiveness comparable to that of other techniques. We expect that this new technique could reduce the operation time and the bleeding and improve the effectiveness of enucleation.
铥激光是最近引入的用于良性前列腺增生（BPH）手术治疗的技术。直到最近，大多数前列腺铥激光剜除术（ThuLEP）都是采用三叶技术进行的。我们介绍一种用于ThuLEP的新型单叶剜除技术，称为“一体化”技术。在此报告我们的初步经验。
2013年6月至2014年5月，共有47例患者由一名外科医生采用ThuLEP“一体化”技术治疗有症状的BPH。所有患者在手术前和术后1个月均接受国际前列腺症状评分（IPSS）、经直肠超声检查、血清前列腺特异性抗原（PSA）、最大尿流率（Qmax）和残余尿量（PVR）评估。术后3个月我们重新评估了IPSS、Qmax和PVR。为评估“一体化”技术的疗效，我们检查了PSA降低率、移行区体积缩小率和剜除失败率。
平均手术时间为82.1±33.3分钟。平均剜除时间和粉碎时间分别为52.7±21.7分钟和8.2±7.0分钟。平均切除组织重量和血红蛋白下降分别为36.9±24.6 g和0.4±0.8 g/dL。所有围手术期参数均有显著改善（p<0.05）。未观察到重大并发症。PSA降低率、移行区体积缩小率和剜除失败率分别为0.81、0.92和4.3%。
ThuLEP“一体化”技术显示出与其他技术相当的疗效。我们期望这种新技术能够减少手术时间和出血，并提高剜除效果。
