Weng Shu-Chuan, Tsao Shu-Han, Tsai Han-Yu, Juang Horng-Heng, Lin Yu-Hsiang, Chang Phei-Lang, Chen Chien-Lun, Hou Chen-Pang
Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu 330, Taiwan.
Bachelor Degree Program of Senior Health and Management, Yuanpei University of Medical Technology, Hsinchu 330, Taiwan.
Diagnostics (Basel). 2023 Feb 6;13(4):592. doi: 10.3390/diagnostics13040592.
Bleeding during endoscopic prostate surgery is often overlooked, and appropriate measurement techniques are rarely applied. We proposed a simple and convenient method for assessing the severity of bleeding during endoscopic prostate surgery. We determined the factors affecting bleeding severity and whether they affected the surgical results and functional outcomes. Records from March 2019 to April 2022 were obtained for selected patients who underwent endoscopic prostate enucleation through either 120-W Vela XL Thulium:YAG laser or bipolar plasma enucleation of the prostate. The bleeding index was measured using the following equation: irrigant hemoglobin (Hb) concentration (g/dL) × irrigation fluid volume (mL)/preoperative blood Hb concentration (g/dL) × enucleated tissue (g). Our research revealed that patients who underwent surgery employing the thulium laser, those aged over 80 years, and those with a preoperative maximal flow rate (Qmax) of more than 10 cc/s experienced less surgical bleeding. The patients' treatment outcomes differed depending on the severity of the bleeding. Enucleating prostate tissue was easier in the patients with less severe bleeding, who also had a lower risk of developing urinary tract infections and an improved Qmax.
内镜下前列腺手术中的出血常常被忽视，且很少应用合适的测量技术。我们提出了一种简单便捷的方法来评估内镜下前列腺手术中的出血严重程度。我们确定了影响出血严重程度的因素，以及这些因素是否会影响手术结果和功能结局。收集了2019年3月至2022年4月期间接受120瓦Vela XL掺铥钇铝石榴石激光或双极等离子体前列腺剜除术的选定患者的记录。使用以下公式测量出血指数：灌洗液血红蛋白（Hb）浓度（克/分升）×冲洗液体积（毫升）/术前血液Hb浓度（克/分升）×剜除组织（克）。我们的研究表明，接受铥激光手术的患者、年龄超过80岁的患者以及术前最大尿流率（Qmax）超过10毫升/秒的患者手术出血较少。患者的治疗结果因出血严重程度而异。出血较轻的患者剜除前列腺组织更容易，发生尿路感染的风险也较低，且Qmax有所改善。
