Dovlatian A A
Klin Med (Mosk). 1995;73(4):68-72.
Outcomes of radical surgery for prostatic adenoma have been analyzed for 426 patients divided into 3 groups. Group 1 included 160 patients subjected to urgent adenomectomy for acute urine retention, group 2 comprised 166 patients with severe intercurrent diseases subjected to one- and two-stage radical surgery, group 3 of 100 patients was free of intercurrent diseases. Urgent and delayed (within 72 hours and 5-10 days, respectively) radical adenomectomies are thought valid in management of acute urinary retention in patients with prostatic adenoma. Adequate preoperative preparation in deficient circulation, diabetes mellitus and other preexisting or concurrent diseases increased by 20-30% indications to the operation. Good outcomes were reported in 90%, 81.4% and 94% of patients from group 1, 2 and 3, respectively. 98.7% of 388 patients avoided suprapubic fistula and resumed natural urination. Only 1.3% of patients were discharged with cystostomy drainage of the bladder because of urethral stricture, urethrorectal fistula, renal failure and pyelonephritis. The differential approach provided good outcomes in 87.6% of seriously ill patients in overall hospital lethality 8.9%. The majority of the lethal outcomes resulted from purulent pyelonephritis (71%). The rest cases were due to acute affections of circulation, respiration and digestion.
对426例接受前列腺腺瘤根治性手术的患者进行了分析，这些患者被分为3组。第1组包括160例因急性尿潴留而接受急诊腺瘤切除术的患者，第2组由166例患有严重并发疾病并接受一期和二期根治性手术的患者组成，第3组100例患者无并发疾病。急诊和延迟（分别在72小时内和5 - 10天内）根治性腺瘤切除术被认为对前列腺腺瘤患者急性尿潴留的治疗有效。对循环系统不足、糖尿病和其他原有或并发疾病进行充分的术前准备，使手术指征增加了20 - 30%。第1、2、3组患者的良好预后报告率分别为90%、81.4%和94%。388例患者中有98.7%避免了耻骨上瘘并恢复了自主排尿。仅1.3%的患者因尿道狭窄、尿道直肠瘘、肾衰竭和肾盂肾炎而带膀胱造瘘引流出院。在总体医院死亡率为8.9%的情况下，差异治疗方法在87.6%的重症患者中取得了良好效果。大多数致命结局是由脓性肾盂肾炎（71%）导致的。其余病例是由于循环、呼吸和消化系统的急性病变。
