Department of Radiology, Chonbuk National University Hospital, 20, Geonji-ro, Deokjin-gu, Jeonju-si, Chonbuk, Republic of Korea.
Department of Radiology, Chonbuk National University Hospital, 20, Geonji-ro, Deokjin-gu, Jeonju-si, Chonbuk, Republic of Korea.
J Vasc Interv Radiol. 2019 May;30(5):655-660. doi: 10.1016/j.jvir.2019.01.004.
To investigate the safety and effectiveness of preoperative prostatic artery embolization (PAE) in relation to decrease in hemoglobin level, requirement for blood transfusion, length of hospitalization, and procedure-related complications.
Ten consecutive patients who underwent surgery after preoperative PAE were identified from May 2017 to October 2018 (embolization group: holmium-laser enucleation of the prostate [HoLEP] in 6 patients and robotic simple prostatectomy in 4 patients, mean age 72.9 ± 8.7 years, mean prostatic volume 106.5 ± 22.0 mL). For comparison, consecutive patients with a large prostatic volume (≥70 mL) who underwent surgery without preoperative PAE during the same period were enrolled (nonembolization group: HoLEP in 9 patients and robotic simple prostatectomy in 1 patients, mean age 71.2 ± 5.7 years, mean prostatic volume 87.8 ± 26.7 mL).
PAE was technically successful in 90% of patients (9/10). The median interval between PAE and surgery was 2 days. The mean hemoglobin reduction was lower (1.40 ± 0.92 g/dL vs 3.07 ± 1.50 g/dL; P = .008) and the median length of hospitalization was shorter (8.5 days vs 11 days; P = .039) in the embolization group than the nonembolization group. The operating time (mean for HoLEP 146 ± 38 min vs 179 ± 59 min [P = .248], mean for robotic simple prostatectomy 223 ± 32 min vs 354 min) and number of blood transfusion (1 patient vs 2 patients; P = .392) were not significantly different between the 2 groups. None of the patients developed any complications except bleeding requiring transfusion.
Preoperative PAE is safe and may reduce blood loss during prostate surgery.
研究前列腺动脉栓塞术（PAE）术前降低血红蛋白水平、输血需求、住院时间和与手术相关并发症的安全性和有效性。
2017 年 5 月至 2018 年 10 月，10 例连续接受 PAE 术前手术的患者（栓塞组：6 例钬激光前列腺剜除术[HoLEP]和 4 例机器人单纯前列腺切除术，平均年龄 72.9 ± 8.7 岁，平均前列腺体积 106.5 ± 22.0 mL）。为了比较，在同一时期，纳入了连续患有大前列腺体积（≥70 mL）但未经术前 PAE 手术的患者（非栓塞组：9 例 HoLEP 和 1 例机器人单纯前列腺切除术，平均年龄 71.2 ± 5.7 岁，平均前列腺体积 87.8 ± 26.7 mL）。
90%（9/10）的患者 PAE 技术成功。PAE 与手术之间的中位间隔时间为 2 天。血红蛋白下降幅度较低（1.40 ± 0.92 g/dL 比 3.07 ± 1.50 g/dL；P =.008），栓塞组的中位住院时间较短（8.5 天比 11 天；P =.039）。HoLEP 的手术时间（平均 146 ± 38 分钟比 179 ± 59 分钟[P =.248]，机器人单纯前列腺切除术的手术时间为 223 ± 32 分钟比 354 分钟）和输血人数（1 例比 2 例；P =.392）在两组之间无显著差异。除需要输血的出血外，两组患者均未发生任何并发症。
PAE 术前安全，可减少前列腺手术中的失血。
