腹腔镜经腹腹膜前疝修补术在腹股沟疝合并前列腺增生症患者术中应用(附70例报告)

Safety and curative efficacy of combining PKRP and TAPP in treatment of BPH complicated with inguinal hernia:a report of 70 cases

目的探讨腹腔镜经腹腹膜前疝修补术(TAPP)同期前列腺等离子电切术(PKRP)治疗腹股沟疝合并前列腺增生症的安全性和疗效。方法回顾性分析2011年11月至2015年1月,70例腹股沟疝合并前列腺增生症患者的临床资料,本组患者先行经尿道等离子前列腺电切术,后行经腹腹膜前疝修补术,观察手术安全性及疗效。结果 70例均同期完成手术,术后随访18~36个月,平均27个月,疝均未复发。最大尿流率为17~28 ml/s,平均(22±3)ml/s;国际前列腺症状评分2~10分,平均(4.9±2.5)分。膀胱残余尿量0~40 ml,平均(19±6)ml。上述3个指标与术前比较,差异有统计学意义(P<0.01)。结论对腹股沟疝合并前列腺增生症患者行经尿道等离子前列腺电切术同期经腹腹膜前疝修补术,双微创治疗、安全有效、并发症少,疗效满意。

Objective To investigate the safety and curative efficacy of transurethral plasmakinetic resection of the prostate （PKRP） in combination with laparoscopic trans-abdominal preperitoneal repair （TAPP） in the treatment of patients with benign prostatic hyperplasia （BPH） complicated with inguinal hernia.Methods From November 2011 to January 2015, a retrospective analysis was conducted.The participants of this study included 70 patients of BPH complicated with inguinal hernia who initially underwent the PKRP procedure immediately followed with the TAPP repair.The safety and curative efficacy of the surgical procedures were investigated.Results Surgery of all 70 cases was completed during the same period of time.Postoperative follow-up was conducted for a period of 18 to 36 months, with an average of 27 months.There was no reoccurrence of hernias in any of the cases.Qmax value was 17 to 28 ml/s, mean of （22＆#177;3） ml/s.IPSS score was 2 to 10 points, mean of （4.9 ＆#177; 2.5） points.Residual urine volume was 0 to 40 ml, mean of （19＆#177;6） ml.The differences between the preoperative and postoperative results of the 3 aforementioned indicators were found to be significant （P〈0.01）.Conclusion Patients of BPH complicated with inguinal hernia treated through a combination of PKRP and TAPP are found to be both safe and effective procedures with minimal complications.Therefore, the overall curative efficacy is satisfactory.