120W2μm激光前列腺剜除术治疗良性前列腺增生

目的：探讨经尿道120W2μm激光前列腺剜除术治疗良性前列腺增生（BPH）的手术操作技巧，评价其有效性和安全性。方法：82例BPH患者应用120W2μm激光前列腺剜除术治疗，前列腺超声测得前列腺体积30～160ml，平均（60．2士15．8）ml。记录术中操作时间、出血量、手术前后尿动力学参数及术后并发症。结果：手术均顺利完成。手术时间32～145min，平均（72．0±26．6）min，无输血病例。平均留置尿管3．6天。8例术后出现并发症，包括暂时出血2例，5例泌尿系感染1例，1例因泌尿系感染术后1周后再次置入尿管，无尿失禁。术后随访3～12个月，平均最大尿流率（Q…）由术前（3．5±4．7）ml／s增至（18．6±5．6）ml／s，剩余尿量（PVR）（125．4±218．4）ml降至（23．4±31．5）ml。大体积（≥60m1）和小体积（〈60m1）前列腺两组患者留置尿管时间…Q。、PVR等差异无统计学意义。结论：120W2μm激光前列腺剜除术治疗BPH效果良好，并发症少，学习曲线较短，且不受前列腺体积限制。但应注意手术技巧的掌握。

120 W 2 Micron Continuous-Wave Laser Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia

Objective:To discuss the skills in the operative procedure and to evaluate feasibility and efficiency of RevoLix 120 Watt 2 micron continuous-wave laser enucleation for the treatment of benign prostatic hyperplasia. Methods:Enucleation was performed using a 120 W 2 micron continuous wave-laser for 60 BPH patients.Mean prostatic volume was 30-160（60.2±15.8）ml.Transfusion rate,resection time,time of indwelling catheter,improvement in mean urinary peak flow rate(Q_max),post-voiding residual urine（PVR）,international prostate symptom score（IPSS） and quality of life（QOL）were measured Complications were recorded.Results:All cases were completed successfully.OR-time was 32-145（72.0±26.6）min,Transfusions were not necessary in any patients. Foley catheter-time was 3.6 days on average.Eight complications were recorded,including bleeding（2）,urinary tract infection（5）,re-catheterization due to urinary tract infection 1 weeks postoperatively（1）.None had incontinence. All cases were followed up for 3-12 months,Mean Qmax improved from（3.5±4.7）ml/s to（18.6±5.6）ml/s and PVR decreased from（125.4±218.4）ml to（23.4±31.5）ml.Comparing the peri-and postoperative outcome,no statistical differences could be found between patients with a prostatic volume of more 60ml and below 60ml.Conclusions:120 Watt 2 micron continuous-wave laser enucleation is an excellent treatment for BPH, learning curve of enucleation is short and complications are minimal.Technically,there is no limitation in prostatic sizewhich allows treating patients with larger prostates.But we should improve our technique in the operative procedure.