Lent V, Neuss A
Department of Urology, St. Nikolaus Stiftshospital, Bonn University Academic Teaching Hospital, Andernach, Germany.
Eur Urol. 1997;32(3):257-67.
The objective of the present study was to establish the therapeutic value of early coagulation of severe postoperative bleeding after transurethral prostate resection in unselected patients.
In a prospective study of 772 prostate resections carried out in 617 patients, bleeding complications, hemostatic measures, blood transfusions, catheter removals, and catheter-related and general complications were registered, and the factors influencing them were analyzed.
Severe postoperative bleeding was coagulated endoscopically on the day of the operation in 70 resections (9.1%), and after removing the catheter in a further 19 cases (2.7%). Blood was transfused perioperatively in 14 patients (2.3%): in 11 patients (2.0%) because of preoperative anemia, and in 3 patients (0.3%) because of postoperative hemorrhage. In 96.3% of the resections, the catheter was removed on the first postoperative day, and in the last year of the study in 99.3% of the cases. Neither additional hemostasis nor early catheter removal had disadvantageous consequences.
Transurethral prostate resections can be performed without any blood transfusion in more than 99.0% of patients without preexisting risk when severe postoperative hemorrhage is coagulated at an early stage. Moreover, this enables early catheter removal, after 24 h at the latest, in more than 99.0% of the cases.
本研究的目的是确定在未经过挑选的患者中，经尿道前列腺切除术后早期凝血对严重术后出血的治疗价值。
对617例患者进行的772例前列腺切除术进行前瞻性研究，记录出血并发症、止血措施、输血情况、导尿管拔除情况以及与导尿管相关的和一般并发症，并分析影响这些情况的因素。
70例切除术（9.1%）在手术当天通过内镜进行了严重术后出血的凝血处理，另有19例（2.7%）在拔除导尿管后进行了处理。14例患者（2.3%）围手术期输血：11例患者（2.0%）因术前贫血输血，3例患者（0.3%）因术后出血输血。在96.3%的切除术中，术后第一天拔除导尿管，在研究的最后一年，这一比例为99.3%。额外的止血措施和早期拔除导尿管均未产生不利后果。
在不存在先前风险的患者中，超过99.0%的患者在严重术后出血早期进行凝血处理后，经尿道前列腺切除术可以不进行任何输血。此外，这使得超过99.0%的病例能够在最迟24小时后早期拔除导尿管。
