2 μm激光剥橘式前列腺切除术治疗大体积前列腺的疗效观察

目的:评估2μm激光剥橘式前列腺切除术(TmLRP-TT)治疗大体积前列腺(70 ml)的临床疗效及安全性。方法:回顾性分析2009年11月至2011年11月上海交通大学附属第一人民医院泌尿外科中心收治的BPH患者80例,术前经直肠超声检查(TRUS)前列腺体积均70 ml,采用2μm激光剥橘式前列腺切除术进行治疗,比较并分析患者手术前后血红蛋白、电解质变化,记录术中及术后并发症,并对患者进行12个月的随访,随访内容包括前列腺症状评分(IPSS)、生活质量评分(QoL)、最大尿流率(Qmax)、残余尿量(PVR)。结果:所有手术均一次顺利完成。术中血红蛋白下降(0.68±0.43)g/dL,电解质未发生明显变化。与术前相比,患者下尿路症状均得到明显改善,术后12个月IPSS下降73.89%[(20.03±6.9)分vs(5.23±3.59)分](P0.01),QoL下降64.55%[(4.09±1.19)分vs(1.45±1.36)分](P0.01),Qmax提高140.42%[(8.04±3.62)ml/s vs 19.33±3.28)ml/s](P0.01),PVR下降79.30%[(97.31±57.90)ml vs(20.14±24.20)ml](P0.01)。围手术期及术后12月随访期内,并发症发生率较低。结论:经尿道2μm激光剥橘式前列腺切除术治疗大体积前列腺是一种安全有效的微创治疗方法。

Two-micron laser resection of the prostate-tangerine technique for the treatment of large-volume prostate

Objective ： To evaluate the clinical efficiency and safety of two-micron laser resection of the prostate-tangerine tech- nique （TmLRP-TT） for the treatment of large-volume （ 〉 70 ml） prostate in patients with benign prostatic hyperplasia （BPH）. Methods ： This retrospective analysis included 80 BPH patients with the prostatic volume larger than 70 ml, all treated by TmLRP-TI＇. We comparatively analyzed the levels of hemoglobin and serum sodium before and after surgery, recorded intra- and post-operative com-plications, and followed up the patients at 6 and 12 months after operation for International Prostate Symptom Score （IPSS）, quality of life （QOL）, maximum flow rate （Qmax）, and postvoid residual urine volume （PVR）. Results： All the operations were successfully completed. The mean hemoglobin decreased （0.68 ± 0.43） g/dl intraoperatively, but no apparent reduction was observed in serum so- dium. Lower urinary tract symptoms were relieved significantly in all the cases. At 12 months after surgery, IPSS was decreased by 73.89% as compared with the baseline （20.03± 6.9 vs 5.23 ± 3.59）, QOL by 64.55% （4.09 ±1.19 vs 1.45± 1.36）, and PVR by 79.30% （97.31± 57.90 vs 20.14 ±24.20 ml）, while Qmax increased by 140.42% （ [ 8.04±3.62 ] vs [ 19.33 ± 3.28 ] ml/s）. The incidence of complications was low either intraoperatively or during the 12 months after operation. Conclusion ： TmLRP-TT is a safe and effective surgical endoscopic approach to the treatment of large-volume prostate in BPH patients.