Rippa A, Sangalli C, Nicolai N, Arena D, Tzoumas S, Franch L
Divisione di Urologia, Ospedale Clinicizzato San Donato, Milano.
Chir Ital. 1998;50(1):25-31.
First choice therapy of obstructive prostatic hyperplasia is still represented by endoscopic transurethral resection of the prostate, despite new techniques for tissue ablation have being proposed. The issue aims to answer to the questions arising about indications of this procedure, and introduces to the knowledge of physical laws which regulate irrigation during and after operation and to the different techniques of irrigating flow derivation whose application reduced morbidity depending on tissue volume and "resection time". Moreover, the new technique of continuous resection with simultaneous suprapubic evacuation of tissue chips (Turbo-TUR) will be illustrated in details, as it permitted to extend indications and advantages of endoscopic surgery to bulky adenomas, electively submitted to open surgery up to now.
尽管已经提出了新的组织消融技术,但经尿道前列腺内镜切除术仍然是前列腺增生梗阻的首选治疗方法。本文旨在回答有关该手术适应症出现的问题,并介绍在手术期间和手术后调节冲洗的物理定律以及不同的冲洗引流技术,其应用可根据组织体积和“切除时间”降低发病率。此外,将详细说明同时经耻骨上清除组织碎片的连续切除术新技术(Turbo-TUR),因为它能够将内镜手术的适应症和优势扩展到巨大腺瘤,而巨大腺瘤到目前为止一直选择开放手术。