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前列腺体积对经尿道等离子前列腺剜除术围手术期和术后结局的影响:892 例患者 3 年随访结果。

Influence of prostate size on the perioperative and postoperative outcome of transurethral plasmakinetic enucleation of the prostate: Results of 892 patients with 3 years of follow-up.

机构信息

Department of Urology, Fuzhou General Hospital, Xiamen University, Fuzhou, Fujian, China.

Department of Urology, Fuzhou General Hospital, Xiamen University, Fuzhou, Fujian, China.

出版信息

Kaohsiung J Med Sci. 2018 Oct;34(10):576-582. doi: 10.1016/j.kjms.2018.03.001. Epub 2018 Mar 30.

Abstract

To explore the influence of prostate size on the outcome of Plasmakinetic enucleation of the prostate (PkEP) for the treatment of benign prostate hyperplasia (BPH), The data of 892 patients with symptomatic BPH who underwent PkEP were retrospectively reviewed. Among them, 199 (22.31%) had the prostate size smaller than 40 g (Group 1), 409 (45.85%) between 40 and 79 g (Group 2), 197 (22.09%) between 80 and 120 g (Group 3), and 87 (9.75%) larger than 120 g (Group 4). Perioperative variables, perioperative and postoperative complications were recorded. Patients were followed up for 36 months postoperatively. The efficiency of the surgery increased as the prostate size increased. Greater decreases in hemoglobin were noted in groups with larger prostates, while the duration of catheterization after the operation was similar across all groups. During the 3-year follow-up, the postoperative improvement in International Prostate Symptom Score (IPSS), Quality of Life (QOL), maximal flow rate (Qmax) and post-void residual urine volume (PVR), as well as longterm complications including urethral stricture and bladder-neck contracture were comparable across the 4 groups. These findings revealed that PkEP is more efficient for large prostate and can treat all prostates regardless of the size with equivalent symptom relief and micturition improvement.

摘要

为了探讨前列腺体积对经尿道等离子前列腺剜除术(PKEP)治疗良性前列腺增生(BPH)疗效的影响,回顾性分析了 892 例接受 PKEP 治疗的有症状 BPH 患者的资料。其中前列腺体积小于 40g 的患者 199 例(22.31%)(1 组),40-79g 的患者 409 例(45.85%)(2 组),80-120g 的患者 197 例(22.09%)(3 组),大于 120g 的患者 87 例(9.75%)(4 组)。记录围手术期变量、围手术期和术后并发症。所有患者术后随访 36 个月。随着前列腺体积的增大,手术效率逐渐提高。前列腺体积越大,血红蛋白下降幅度越大,而术后导尿管留置时间在各组之间相似。在 3 年随访期间,4 组患者的国际前列腺症状评分(IPSS)、生活质量(QOL)、最大尿流率(Qmax)和残余尿量(PVR)的术后改善情况以及尿道狭窄和膀胱颈挛缩等长期并发症发生率均无显著差异。这些发现表明,PKEP 治疗大体积前列腺更有效,无论前列腺体积大小,均可达到同等的症状缓解和排尿改善效果。

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