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[冷冻手术治疗前列腺肿瘤的并发症]

[Complications of cryosurgery in the treatment of prostatic tumors].

作者信息

Reuter H J

出版信息

Arch Esp Urol. 1978 May-Jun;31(3):213-24.

PMID:80975
Abstract

Most of the complications in cryosurgery (pyelonephritis, peritonitis, perforations and haemorrhages) are caused by an indequate control of the freezing process or by the use of unsuitable cryosurgical techniques. To this effect, an important role is played by the unsuitable choice of the kind of freezing probe and the use of an unsuitable freezing time. Only endoscopic cryosurgery enables a precise and exact control by means of viewing through the endoscopic trocar along with simultaneous rectal feeling, both of which enable us to achieve an exact supervision of the size of the subvesically-formed freezing sphere adjacent to the rectum. Short, repeated freezings prevent the risk of necrosis (called "sloughts" by English authors). There is a 2% mortality, bearing in mind that the casuistry in cryosurgery is similar to the normal one in open prostate surgery with the difference in favour of the former that these patients generally belong to the so-called inoperable group or with a special surgical risk and aged between 70 and 80 years old. On the other hand, in both groups of our casuistry, the U.T.R. produced a mortality of only 0.3%.

摘要

冷冻手术中的大多数并发症(肾盂肾炎、腹膜炎、穿孔和出血)是由于冷冻过程控制不当或使用了不合适的冷冻手术技术所致。为此,冷冻探头种类选择不当以及冷冻时间使用不当起着重要作用。只有内镜冷冻手术能够通过内镜套管进行观察并同时进行直肠触摸来实现精确控制,这两者使我们能够准确监测直肠附近膀胱下形成的冷冻球的大小。短时间、反复冷冻可防止坏死风险(英国作者称之为“脱落”)。死亡率为2%,要记住冷冻手术的病例情况与开放性前列腺手术的正常情况相似,不同之处在于前者更有利,因为这些患者通常属于所谓的不可手术组或具有特殊手术风险,年龄在70至80岁之间。另一方面,在我们的两组病例中,经尿道切除术的死亡率仅为0.3%。

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