腹腔镜与经尿道腔内剜除行大体积前列腺切除术的效果比较

Laparoscopic and transurethral plasmakinetic enucleation of prostate simple prostatectomy of large prostatic adenomas

目的通过比较,评价腹腔镜与经尿道等离子逆行剜除手术(PKEP)行大体积前列腺切除术治疗良性前列腺增生(BPH)的临床价值。方法回顾性分析腹腔镜及PKEP手术行大体积前列腺切除术的临床资料,就两组手术的手术时间、术中出血量、术后膀胱冲洗及尿管留置时间、术后止痛剂的用量、术后住院时间、住院费用、术后恢复轻体力劳动的时间、术后并发症、两种手术方式术前与术后国际前列腺症状评分(IPSS)、平均生活质量评分(QOL)及最大尿流率(Qmax)等指标进行比较。结果腹腔镜组与PKEP组术中的出血量、术后膀胱冲洗及尿管留置时间、术后止痛剂的用量、术后住院时间、术后恢复轻体力劳动的时间、住院总费用及术后并发症等方面的差异无显著性(P>0.05);两组术后IPSS、QOL及Qmax等指标较术前明显改善(P<0.01);PKEP组在手术时间方面优于腹腔镜组,差异有显著性(P<0.05)。结论两种术式治疗大体积BPH均有满意疗效,具有有效、安全及微创等优点,但PKEP在手术时间方面更有优势,是可供选择的治疗大体积BPH较为理想的方法,值得推广应用。

[ Objective ] To evaluate the clinical value of laparoscopic simple prostatectomy compared with transurethral plasmakinetic enncleation of prostate（PKEP） simple prostatectomy for benign prostate hyperplasia（BPH）. [ Methods ] The clinical data of laparoscopic and PKEP simple prostatectomy for large prostatic adenomas were ret- rospectively analyzed.Operating time,perioperative blood loss,postoperative irrigation time and duration of catheteri- zation, hospital stay, analgesics usage, total cost of hospitalization,return to normal activity time,complication and postoperative parameters of Quality of International Prostate Score Symptoms （IPSS）, Quality of Life questionnaires （QOL） and Maximum Flow Rate （Qmax） were compared between the two groups. [Results] In the laparoscopic prostatectomy and PKEP group, the parameters of blood loss during operation,postoperative irrigation time and dura- tion of catheterization, analgesics use after operation, hospital stay after operation, return to normal activity time and the total cost of hospitalization were no significant difference （P 〉0.05）. The postoperative parameters of IPSS, QOL and Qmax were significantly improved than that of perioperative of each group （P〈0.01）. Operating time was signifi- cantly less in the PKEP group than in the laparoscopic group（P 〈0.05）. [ Conclusions ] The two surgical procedures have significant efficacy in the treatment of large BPH. But the operating time of PKER has more superiority than those of laparoscopy, so PKER deserves application.