腹腔镜下Madigan前列腺剜除术治疗大体积良性前列腺增生的疗效观察

目的 探讨腹腔镜下Madigan前列腺剜除术治疗大体积良性前列腺增生(BPH)的可行性及临床价值.方法 2008年11月至2010年1月收治大体积(＞90 g)BPH患者24例.年龄62～72岁,平均65岁.经估算的前列腺重量(132.3±21.9)g;残余尿量(143.2±23.2) ml; IPSS(28.6±3.8)分,QOL(5.5±2.4)分,MFR(5.4±2.3) ml/s.24例均行腹腔镜下Madigan前列腺剜除术.统计学比较患者术前和术后3个月的IPSS、QOL及MFR差异,分析评价手术疗效.结果 24例手术均成功.术中出血量(112.5±47.8) ml,切除前列腺重量(104.7 ±23.3)g,膀胱冲洗时间(1.3±0.9)d,留置引流管时间(2.3±0.5)d,留置尿管时间(3.1±0.4)d,术后住院时间(3.5±0.8)d.术后3个月患者IPSS(4.5±1.8),QOL( 19.9±3.1),MFR( 18.5±2.9) ml/s,与术前比较差异有统计学意义(P＜0.05).结论 腹腔镜下Madigan前列腺剜除术是治疗大体积BPH安全有效的方法.

Clinical efficacy of laparoscopic Madigan enucleation in the treatment of BPH with large prostate volume

Objective To assess the feasibility and clinical efficiency of laparoscopic Madigan enucleation of the prostate for the treatment of benign prostatic hyperplasia (BPH) with large prostate.Methods From Nov.2008 to Jan.2010,24 eases of BPH patients with large prostate ( ＞90 g) were treated in our institute by laparoscopic Madigan enucleation.The average patient's age was 65.2 yrs,the average prostate weight were 132.3 ± 21.9 g,preoperative residual urine was 143.2 ± 23.2 ml,average IPSS was 28.6 ± 3.8,average QOL was 5.5 ± 2.4 and average MFR was 5.4 ± 2.3 ml/s.All patients accepted the laparoscopic Madigan enucleation of the prostate.The pre-surgery and three months post-operative IPSS,QOL,and MFR were compared and analyzed.Results All 24 patients successfully completed the surgery.The resected prostate tissue weight was 104.7 ± 23.3 g,blood loss was 112.5 ± 47.8 ml,postoperative hospital stay was 3.5 ± 0.8 d,bladder irrigation time was 1.3 ± 0.9 d,drainage time was 2.3 ± 0.5 d and catheterization time was 3.1 ±0.4 d.Three months after surgery,patient's IPSS was 4.5 ± 1.8,QOL was 19.9 ±3.1,and MFR was 18.5 ±2.9 ml/s.All the parameters significantly improved compared with the pre-surgery data ( P ＜ 0.05 ).Conclusions Laparoscopic Madigan enucleation of the prostate is a safe and effective method in the treatment of BPH with large prostate volume.