A multi-center comparative study on the transurethral prostate enucleation with 2 μm laser versus the transurethral resection prostatectomy in the treatment of benign prostatic hyperplasia
-
摘要: 目的：比较经尿道2 μm激光前列腺剜除术与经尿道前列腺电切术（TURP）治疗BPH的疗效和安全性。方法：在三家医疗中心随机采用经尿道2 μm激光前列腺剜除术和TURP两种手术方式治疗BPH患者各84例，比较分析两组患者术中及术后的相关临床指标。两组患者术前一般情况比较差异无统计学意义（P>0.05）。结果：三家医疗中心所有患者均手术成功。切除前列腺重量2 μm激光组（19.96±13.57） g与TURP组（19.10±8.53） g比较，差异无统计学意义；2 μm激光组手术时间（100.7±27.8） min显著大于TURP组（88.15±30.72） min（P<0.01）；2 μm激光组术中出血量（22.73±10.9） ml小于TURP组术中出血量（63.8±23.8） ml，两组间比较差异有统计学意义（P<0.01）；所有患者术后国际前列腺症状评分、生活质量评分及最大尿流率均较术前明显改善（P<0.01）。结论：经尿道2 μm激光前列腺剜除术与TURP治疗BPH近期疗效相当；2 μm激光前列腺剜除术具有良好的止血效果，在手术中可更彻底切除增生前列腺组织，显著降低手术风险性，是一种治疗BPH安全、有效的微创手术方式。Abstract: Objective: To compare the therapeutic effects of the transurethral prostate enucleation with 2 μm laser and transurethral resection prostatectomy(TURP) for the treatment of benign prostatic hyperplasia(BPH).Method: One hundred and sixty-eight cases of BPH were divided into two groups randomly underwent transurethral prostate enucleation with 2 μm laser and TURP in three hospitals. There were 84 cases in each group and was no significant difference between the two groups in some preoperative factors (P>0.05). The clinic data were analyzed.Result: All operation were successful. There was no significant difference in excised volume between 2 μm laser group (19.96±13.57) g and TURP group (19.10±8.53) g. The operation time of TURP (88.15±30.72) min was significant shorter than that for transurethral prostate enucleation with 2 μm laser (100.7±27.8)(P<0.01). There were significant difference for blood loss during operation between 2 μm laser group (22.73±10.9) ml and TURP group (63.8±23.8) ml(P<0.01). The IPSS, QOL and Qmax were improved significantly after operation in both groups (P<0.01).Conclusion: The transurethral prostate enucleation with 2 μm is superior to TURP in safety, blood loss and resection thoroughness, and as efficacious as TURP. The transurethral prostate enucleation with 2 μm laser is a safe and effective minimally invasive treatment for BPH.
-
Key words:
- benign prostatic hyperplasia /
- 2 micron laser /
- enucleation /
- transurethral resection
-
-
[1] UCHIDA T, 0HORI M, SOH S, et al. Factors influencing morbidity in patients undergoing transurethral resection of the prostate[J].J Uro1, 1999, 53:98-105.
[2] SUN D C, YANG Y, WEI Z T, et al. Transurethral dividing vaporesection for the treatment of large volume benign prostatic hyperplasia using 2 micron continuous wave laser[J]. Chin Med J, 2010, 123(17):2370-2374.
[3] 夏术阶. 铥激光剥橘式前列腺切除术技巧与应用[J]. 国际外科学杂志, 2007, 34(5):358-360.
[4] 郭和清,周高标,刘红明,等. 经尿道2μm激光前列腺剜除术治疗良性前列腺增生的疗效分析[J]. 中华泌尿外科杂志,2011, 32:411-414.
[5] 杨勇,洪宝发,魏志涛,等. 经尿道2μm激光前列腺汽化切除术治疗大体积良性前列腺增生的初步经验[J]. 中华泌尿外科杂志, 2009, 30(3):198-201.
[6] 杨勇,孙东翀,张旭,等. 经尿道2μm激光分割式汽化切除术治疗良性前列腺增生[J]. 中华泌尿外科杂志, 2009, 30(11):753-56.
[7] LIU C X, ZHENG S B, LI H L, et al. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics[J].J Urol, 2010, 184:2440-2445.
[8] SZLAUER R, GOTSCHL R, RAZMARIA A, et al. Endoscopic vaporesection of the prostate using the continuous-wave 2μm thulium laser:outcome and demonstration of the surgical technique[J]. Eur Urol, 2009, 55:368-375.
[9] BACH T, HERRMANN T R, GANZER R, et al. RevoLix vaporesection of the prostate:initial results of 54 patients with a 1-year follow-up[J]. World J Urol, 2007, 25(3):257-262.
[10] FU W L, ZHANG X, YANG Y, et al. Comparison of 2-microm continuous wave laser vaporesection of the prostate and transurethral resection of the prostate:a prospective nonrandomized trial with 1-year follow-up[J]. J Urol, 2010, 75(1):194-199.
[11] BACH T, HERRMANN T R, HAECKER A, et al. Thulium:yttrium-aluminium-garnet laser prostatectomy in men with refractory urinary retention[J]. BJU Int, 2009, 104(3):361-364.
[12] 汪清,艾克拜尔·吾曼尔,王胜军,等. 三种经尿道前列腺切除术治疗良性前列腺增生的疗效比较[J]. 现代泌尿外科杂志,2008,13(1):44-47.
-
计量
- 文章访问数: 128
- PDF下载数: 51
- 施引文献: 0
下载: