Bergero Miguel Ángel, Álvarez Juan Manuel, Cruz Liyo Juan, Dourado Leandro, Menéndez Nicolás, Carlos David, Dipatto Fernando, Tirapegui Sebastián
Sanatorio Privado San Gerónimo. Santa Fe. Argentina.
Clínica Colón. Mar del Plata. Buenos Aires. Argentina.
Arch Esp Urol. 2020 May;73(4):268-273.
The improvements in laparoscopic urological surgery have made laparoscopic adenomectomy (LA) possible in voluminous prostatic adenomas.
The objective of this study was to assess the results of the LA and compared them with results of the open adenomectomy (OA).
A comparative study of 41 patients undergoing LA [23 LA with Millin technique (LA-MT) and 21 with transvesical technique (LA-TV)] was conducted with 44 patients undergoing OL in prostate adenomas > 100 grams. Data were recorded prospectively, at three different institutions. Preoperative, intraoperative, postoperative and complications results were evaluated.
Prostate volume was 165 (100-345) gr for LA versus 170 (100-328) gr for OA (p=0.669). Preoperative IPSS was 3 (0-3) and Q max. 7 (0-15) for LA against 2 (0-3) and 7 (0-15.3) for OA (p=0.296;p=0.316). There was no difference in surgical time (p=0.069) between both techniques. LA had less operative bleeding, 100 (10-1000) ml than OA, 500 (100-1000) ml (p=0.0001) and a shorter hospital stay, 3 (1-8) days against 3.5 (3-10) days (p=0.0001), postoperative IPSS was 1 (1-2) and Q max. 25 (17-45) for LA against 1 (1-3) and 25.5 (12-44) for OA (p=0889;p=836). There were no differences neither in transfusions requirements' nor complications.
LA presented similar short-term functional results with less operative bleeding and shorter hospitalization time than OA with similar prostate volumes resected.
腹腔镜泌尿外科手术的进步使得腹腔镜腺瘤切除术（LA）能够用于治疗体积较大的前列腺腺瘤。
本研究的目的是评估LA的结果，并将其与开放性腺瘤切除术（OA）的结果进行比较。
对41例行LA的患者[23例行Millin技术的LA（LA-MT）和21例行经膀胱技术的LA（LA-TV）]与44例前列腺腺瘤重量>100克的行开放性手术（OL）的患者进行了一项对比研究。数据在三个不同机构前瞻性记录。对术前、术中、术后及并发症结果进行评估。
LA组前列腺体积为165（100 - 345）克，OA组为170（100 - 328）克（p = 0.669）。LA组术前国际前列腺症状评分（IPSS）为3（0 - 3），最大尿流率（Q max）为7（0 - 15）；OA组术前IPSS为2（0 - 3），Q max为7（0 - 15.3）（p = 0.296；p = 0.316）。两种技术在手术时间上无差异（p = 0.069）。LA的术中出血量为100（10 - 1000）毫升，少于OA的500（100 - 1000）毫升（p = 0.0001），住院时间更短，LA为3（1 - 8）天，OA为3.5（3 - 10）天（p = 0.0001），LA术后IPSS为1（1 - 2），Q max为25（17 - 45）；OA术后IPSS为1（1 - 3），Q max为25.5（12 - 44）（p = 0.889；p = 0.836）。在输血需求和并发症方面均无差异。
LA在切除相似前列腺体积时，与OA相比具有相似的短期功能结果，但术中出血更少，住院时间更短。
