经尿道前列腺纽扣式电极等离子汽化剜切术治疗良性前列腺增生症

Transurethral vapor enucleation and resection of prostate with TURis button electrode

目的探讨经尿道前列腺纽扣式电极等离子汽化剜切术治疗良性前列腺增生症的疗效及其安全性。方法2011年7至10月浙江大学医学院附属第一医院泌尿外科应用奥林帕斯（Olympus）等离子纽扣电极结合环状电极行经尿道前列腺等离子汽化剜切术治疗16例良性前列腺增生症患者。我们对前列腺重量，国际前列腺症状评分（IPSS），生活质量指数评分（QOL），手术时间，失血量，尿管留置时间，住院时间，围手术期并发症及切除前列腺组织重量进行了评估。结果本组16例手术均获成功。未发生明显出血及经尿道电切综合征。患者平均年龄（67．3±8．1）岁。术前前列腺重量为19-91g，平均（49±24）g，切除前列腺组织10-50g，平均（36±16）g。围手术期未发生严重并发症。平均手术时间（116±31）min，术后平均留置导尿管时间（4．9±1．8）d。平均住院时间为（16．6±5．5）d。IPSS由术前（15．6±6．8）分降至术后（6．7±2．4）分差异有统计学意义（P〈0．01），QOL由术前（3．4±1．4）分降至术后（1．6±0．6）分（P〈0．01）。结论经尿道前列腺纽扣式电极等离子汽化剜切术是一种治疗BPH安全有效的可选择方法。

Objective To describe an efficient and effective method of using Olympus TURis button plasma vaporization electrode plus loop electrode for transurethral vapor enucleation and resection of prostate. Methods Between July 2011 and October 2011, the investigators performed transurethral vapor enucleation and resection of prostate using Olympus TURis button plasma vaporization electrode plus loop electrode in 16 consecutive patients at our institution. The parameters of prostate weight, International Prostate Symptom Score （IPSS）, quality of life （QOL）, operative duration, blood loss volume, catherization period, duration of hospitalization, perioperative complications and the weight of enucleated tissue were evaluated. IPSS and QOL were recorded during the follow-up. Results No patient had significant blood loss or signs of transurethral resection syndrome. The mean patient age was 67.3 ±8. 1 years. Mean preoperative prostate weight was 49 ± 24 g （range： 19 -91 ） and mean resected tissue weight 36± 16 g （range： 10 -50）. Serious complications were not observed. Operative duration was 116 ± 31 minutes, mean catheter time 4. 9 ±1.8 days and the duration of hospitalization was 16. 6 ± 5.5 days. Transurethral vapor enucleation and resection of prostate induced significant, pronounced, immediate and lasting improvement in IPSS（ 15.6 ± 6. 8 vs 6. 7± 2. 4, P 〈0. 01 ） and QOL （3.4 ± 1.4 vs 1.6 ±0. 6, P 〈 0. 01 ）. Conclusion Transurethral vapor enucleation and resection of prostate with Olympus TURis plasma button electrode is a safe, effective and thorough surgical method in the treatment of benign prostatic hyperplasia.