双极与单极电切术对犬前列腺组织病理学影响的对比研究

目的:对比研究经尿道前列腺等离子体双极电切术(PKRP)与传统单极前列腺电切术(TURP)术后犬前列腺组织创面凝固层厚度及其病理学的变化。方法:25只成年雄性家犬随机分为3组:PKRP组(12只)、TURP组(12只)和假手术对照组(1只)。于术后0(术后立即)、1、2、8周分别取各组动物处死,获取前列腺标本,光镜下观察前列腺组织病理学改变并测量创面凝固层厚度。结果:术后0、1、2周,PKRP组和TURP组前列腺组织创面的凝固层厚度分别为(237.73±20.12)μm、(113.03±16.65)μm、(106.01±16.36)μm和(200.75±19.34)μm、(129.46±17.81)μm、(116.04±25.67)μm,术后0、1周两组相比,差异有统计学意义(P<0.01)。术后8周,PKRP组和TURP组前列腺组织创面凝固层完全脱落,创面均被覆再生的尿路上皮。术后0、1、2、8周,PKRP组和TURP组前列腺组织均有不同程度的炎症反应,凝固层下部分腺腔扩张,上皮破坏。假手术对照组未见上述变化。结论:PKRP和TURP术对犬前列腺组织创面的病理学影响基本相似。但PKRP术中凝固层厚度大于TURP,提示PKRP术中止血性能可能优于TURP;术后早期,PKRP凝固层较TURP薄,提示PKRP间接的穿透性热损伤可能较TURP小。

Bipolar transurethral resection of the prostate versus monopolar transurethral prostatectomy:A pathological study in a canine model

Objective :To compare the postoperative depths of the coagulation zones and pathological changes between bipolar transurethral resection of the prostate with plasmakinetic energy (PKRP) and monopolar transurethral prostatectomy (TURP) in canines. Methods :Twenty-five male dogs were randomly divided into a PKRP group (n = 12),a TURP group (n = 12) and a sham-operation control group (n = 1). The dogs were sacrificed,their prostates harvested at 0 week (immediately after surgery),1 week,2 weeks and 8 weeks postoperatively and sectioned for pathologic analysis and measurement of the coagulation zones. Results :At 0,1 and 2 weeks after the operation,the coagulation depths were (237.73±20.12) μm,(113.03±16.65) μm and (106.01±16.36) μm in the PKRP group,and (200.75±19.34) μm,(129.46±17.81) μm and (116.04±25.67) μm in the TURP group (P<0.01). At 8 weeks,the coagulation zones completely peeled off and the wounds were covered by regenerated urothelia in both of the groups. At 0,1,2 and 8 weeks,different inflammatory reactions were observed in the prostates of the PKRP and TURP groups,with some glandular lumens beneath the coagulation zones expanded and epithelia damaged. However,none of these phenomena occurred in the sham-operation control group. Conclusion :Pathologically,PKRP and TURP inflicted basically similar effects on the prostate of the canine. However,the coagulation zone was deeper intraoperatively and became thinner postoperatively with the former than with the latter,which suggests that PKRP causes less bleeding and less penetrative thermal damage than TURP.