无线智能高清内镜在经尿道双极等离子解剖性前列腺剜除术中的应用初探

Preliminary study on application of wireless intelligent high-definition endoscope in transurethral bipolar plasma anatomical enucleation of prostate

目的探讨一种无线智能高清内镜系统(WHES)在经尿道双极等离子腔内前列腺剜除术(BEEP)中应用的安全性及可行性。方法收集2021年6月至9月在我院接受BEEP治疗的78例前列腺增生(BPH)患者的临床资料,根据术中使用内镜的不同类型分为观察组42例(WHES组)和对照组36例(STORZ组)。比较两组术前准备时间、内镜操作舒适度评分、手术视频清晰度评分及延迟次数和患者部分围手术期结果。结果两组手术均顺利完成。WHES组在术前准备时间[(3.05±0.75)min vs(5.21±1.05)min,P<0.001]及内镜操作舒适度评分[(4.8±0.6)vs(4.2±0.5),P<0.001]均优于STORZ组;两组在手术视频清晰度评分[(4.4±0.5)vs(4.5±0.5),P=0.381]及手术时间[(41.4±18.1)min vs(38.3±16.8)min,P=0.438]上结果相当,且均无视频延迟发生;两组在手术前后血红蛋白下降量、剜除组织重量、术后膀胱冲洗及留置尿管时间、术后住院天数等围手术期结果上差异亦无统计学意义(P>0.05)。结论WHES下BEEP治疗BPH安全可行。WHES简化了传统内镜的设备连接,有利于缩短术前准备时间,提高术者操作舒适度。

Objective To investigate the safety and feasibility of a wireless intelligent high-definition endoscopic system(WHES)in transurethral bipolar plasmakinetic enucleation of the prostate(BEEP).Methods The clinical data of 78 patients with benign prostatic hyperplasia(BPH)treated with BEEP in our hospital from June to September 2021 were collected and divided into observation group(n=42)(WHES group)and control group(n=36)according to different types of endoscopy used during operation.Preoperative preparation time,endoscopic operation comfort score,surgical video clarity score and,number of delays and some perioperative results before discharge were compared between the two groups.Results All operations were successfully completed in both groups.In the WHES group,the preoperative preparation time[(3.05±0.75)min vs(5.21±1.05)min,P<0.001]and endoscopic comfort score[(4.8±0.6)vs(4.2±0.5),P<0.001]were superior to the STORZ group;both groups scored better in surgical video clarity[(4.4±0.5)vs(4.5±0.5),P=0.381]and operative time[(41.4±18.1)min vs(38.3±16.8)min,P=0.438]showed comparable results,and no video delay occurred.There was also no statistically significant difference in perioperative results such as hemoglobin decrease,enucleated tissue weight,postoperative bladder irrigation and indwelling urinary catheter time,and postoperative hospital stay between the two groups(P>0.05).Conclusion BEEP under WHES is safe and feasible in the treatment of BPH.WHES simplifies the instrument connection of conventional endoscopes,reduces preoperative preparation time,and improves operator comfort.