Long Qicheng, Yu Zhe, Lin Guangzheng, Chen Pengliang, Wei Qiang, Tan Wanlong
Department of Urologic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Jan;36(1):131-4.
To investigate the perioperative benefit of suprapubic cystostomy in bipolar transurethral resection of the prostate (B-TURP) for treatment of benign prostatic hyperplasia (BPH) below 80 g.
This retrospective study was conducted in patients undergoing B-TURP for BPH below 80 g, who were stratified with respect of suprapubic cystostomy in B-TURP. The end points including the safety, efficiency, complications and nursing care were compared between the two groups.
A total of 585 patients were enrolled, including 366 in cystostomy group and 219 in non-cystostomy group. The two groups showed similar postoperative reduction of serum sodium (0.06 vs 0.54 mmol/L, P>0.05), hematocrict (2.44% vs 2.89%, P>0.05), and blood hemoglobin concentration (9.62 vs 10.42 g/L, P>0.05), with comparable weight of resected prostate (42.50 vs 43.76 g, P>0.05). The operation time was significantly longer in cystostomy group than in non-cystostomy group (90.75 vs 76.28 min, P<0.05), but the rate of blood transfusion and incidences of postoperative fever and catheter blocking were comparable between the two groups. Compared with the non-cystostomy group, cystostomy group had significantly longer time for bladder washing (3.15 vs 2.57 days, P<0.05), catheter indwelling time (5.19 vs 4.15 days, P<0.05), and hospital stay after the operation (7.36 vs 5.65 days, P<0.05).
In B-TURP for BPH below the weight of 80 g, suprapubic cystostomy is associated with a longer time for operation, bladder washing, catheter indwelling and postoperative hospital stay, and thus provides no obvious benefits for the patients.
探讨耻骨上膀胱造瘘术在80g以下良性前列腺增生(BPH)的双极经尿道前列腺切除术(B-TURP)围手术期的益处。
本回顾性研究纳入了接受80g以下BPH的B-TURP患者,根据B-TURP中是否行耻骨上膀胱造瘘术进行分层。比较两组的终点指标,包括安全性、有效性、并发症及护理情况。
共纳入585例患者,其中膀胱造瘘组366例,非膀胱造瘘组219例。两组术后血清钠降低值(0.06 vs 0.54 mmol/L,P>0.05)、血细胞比容(2.44% vs 2.89%,P>0.05)和血红蛋白浓度(9.62 vs 10.42 g/L,P>0.05)相似,切除前列腺重量相当(42.50 vs 43.76 g,P>0.05)。膀胱造瘘组手术时间显著长于非膀胱造瘘组(90.75 vs 76.28分钟,P<0.05),但两组输血率、术后发热及导尿管堵塞发生率相当。与非膀胱造瘘组相比,膀胱造瘘组膀胱冲洗时间(3.15 vs 2.57天,P<0.05)、导尿管留置时间(5.19 vs 4.15天,P<0.05)及术后住院时间(7.36 vs 5.65天,P<0.05)均显著延长。
在80g以下BPH的B-TURP中,耻骨上膀胱造瘘术会导致手术时间、膀胱冲洗时间、导尿管留置时间及术后住院时间延长,因此对患者无明显益处。