改良Millin前列腺切除术的临床应用(附132例报告)

Clinical Application of Modified Millin Prostatectomy for Benign Prostatic Hy- perplasia: a Report of 132 Cases

目的:提高前列腺增生症患者开放手术的治疗效果。方法:2000年1月-2002年12月对132例前列腺增生症患者采用改良millin前列腺切除手术,其手术要点为前列腺摘除后将膀胱颈部粘膜拉下覆盖缝合于前列腺窝内壁。结果:手术时间50-135 min,平均81.5 min,术中出血50-750 mL平均失血量为150 mL,平均切除前列腺组织重量70.5 g。平均6.5 d,全部病例拔除导尿管、排尿通畅。108例获术后随防3-25月,IPSS自术前平均26.8分下降至4.5分,QOL自平均4.5分降至1.2分,平均最大尿流率自术前6.8 mL/s升至18.6 mL/s,未发现严重的并发症、疗效满意。结论该改良术式尽量保留了尿道粘膜的完整、止血效果好、恢复快、并发症少,是治疗前列腺增生症较理想的手术方法。

Objective: To evaluate the effects of an open operation on prostate hyperplasia. Methods: From Jan. 2000 to Dec. 2002, modified Millin prostatectomy was performed for 132 case of prostate hyperplasia. The key point of the operation technique,especially in hemostasis was that the mucosa of the bladder neck was pulled down to covered the prostatic fossa. Results: The duration of operation was 50-135 min, mean time was 81. 5 min,mean bleeding volume was 150 mL, mean resected prostatic tissue was 70. 5g and the mean duration of indwelling urethral catheter was 6. 5 days. All patients had got normal voiding. 108 patients have been followed up for 3-25 months. IPSS decreased from 26. 8 to 4. 5,QOL from 4. 5 to 1. 2 and Qmax,increased from 6. 8 mL/s to 18. 6 mL/s. No severe complication were found and the effects were satisfied. Conclusion: The modified Millin prostatectomy preserved urethral mucosa,it is an ideal method of operation in treatment of BPH.