经尿道前列腺绿激光汽化术与经膀胱前列腺切除术的近期疗效比较

Greenlight photoselective vaporization of prostate versus suprapubic transvesical prostatectomy for benign prostatic hyperplasia

目的:评价经尿道前列腺选择性绿激光汽化术(PVP)与经膀胱前列腺切除术的近期临床疗效。方法:将BPH患者60例随机分为两组,分别行经尿道前列腺选择性绿激光汽化术(PVP组)和耻骨上经膀胱前列腺切除术(开放手术组),比较两种术式的手术时间、术中出血量、近期疗效及并发症等情况。结果:两组术后前列腺国际症状评分(IPSS)、生活质量评分(QOL)、最大尿流率、剩余尿量均比术前明显改善(P<0.05),但两组上述指标之间比较差异无统计学意义(P>0.05)。PVP组平均手术时间(48.6±15.2min)、术中出血量(58.7±12.4ml)、术后膀胱冲洗时间(1.2±0.8d)、留置尿管时间(1.8±0.5d)、住院时间(4.5±1.2d)及近期并发症发生率明显小于开放手术组(P<0.05)。结论:PVP治疗BPH与耻骨上经膀胱前列腺切除术相比近期疗效相似,具有手术时间短、创伤小、出血少、恢复快、并发症发生率低等特点,是一种治疗BPH安全有效的理想微创术式。

Objective：Objective：To evaluate the clinical effect of different surgical methods of greenlight photoselective vaporization of prostate （PVP） and suprapubic transvesical prostatectomy for the treatment of benign prostatic hyperplasia （BPH）. Methods： Sixty patients with BPH were randomized into two groups treated by either PVP or open prostatectomy. Various parameters such as operation time, blood loss and complications were recorded and analysied. Results：The IPSS, QOL, uroflowmery, postvoid residual urine volume （RUV） were significantly improved if compared with preoperative data （ P 〈0. 05）. No significant difference in the improvement of subjective sympotoms and objective results has been noted with the different procedures（ P 〉0.05）. Average operation time（48.6 ± 15.2 min）, blood loss （58.7 ± 12.4 ml）, bladder irrigating time （ 1.2 ±0.8 d）, indwelling catheterzation（1.8±0.5 d）, postoperative hospital（4.5± 1.2 d）and short-term complication rates in PVP were significant shorter than those in open prostatectomy（ P 〈0.05）. Conclusions：The PVP has similar therapeutic effect as open prostatectomy for the treatment of symptomatic BPH. PVP is regarded as shorter operative and recovering time, minimally invasive procedure, less blood loss and complication for the patients with BPH.