经尿道前列腺电凝化切除术治疗良性前列腺增生症

Transurethral electroresection & coagulation of prostate for benign prostate hyperplasia

目的总结和评估经尿道前列腺电凝化切除术(transurethral electroresection & coagulation of prostate,TURCP)治疗前列腺增生症(BPH)的疗效。方法采用TURP和TUVP以及自创的TURCP治疗BPH共45例。结果本组45例患者中,2例采用德国ERBE ICC 300高频发生器,切割和气化效果差。另43例采用美国威利Force2高频发生器,其中4例采用TURP,5例采用TUVP,余34例采用TURCP。术中出血情况:TURP组180～260mL,平均210mL;TUVP组150～200mL,平均180mL;TURCP组30～70mL,平均45mL。手术时间:TURP组60～110min,平均85min;TUVP组40～80min,平均56min;TURCP组20～40min,平均30min。冲洗液使用量:TURP组38000～52000mL,平均42000mL;TUVP组34000～47000mL,平均39000mL;TURCP组12000～19000mL,平均15000mL。手术均获成功。术中前列腺包膜穿孔3例,使用水平衡镜鞘1例术后出现前尿道狭窄,后尿道狭窄2例,术后再次出血1例。电切综合征(TURS)2例,无死亡病例,无尿失禁病例。结论TURCP治疗BPH创伤小、出血少、疗效好。

[Objective] To evaluate the clinical effect of Transurethral electroresection ＆ coagulation of prostate. [Methods] 45 cases of BPH were treated with TURP, TUVP＆TURCP. [Results] In the 45eases, 2 cases were operated by ERBE ICC 300 electrosurgical generator and 43 cases were operated by Valleylab Force 2 electrosurgical generator. The blood loss was 180-260 mL in TURP, 150-200 mL in TUVP and 30-70 mL in TURCP. The duration of operation was 60-110 min in TURP, 40-80 min in TUVP and 20-40 min in TURCP. The dose of flush liquid was 38 000-52 000 mL in TURP, 34 000-47 000 mL in TUVP and 12 000-19 000 mL in TURCP. There were 3 cases had prostatic envelope perforation in the operation, 1 distal urethral stricture and 2 proximal urethral stricture after the operation, 1 bleeding after operation, 1 TURS, no death and incontinence. [Conclusion] TURCP is of less damage in the treatment of BPH, with little blood loss and good result.