经尿道等离子分区剜除联合Nesbit电切术在巨大良性前列腺增生手术中的应用

Transurethral plasmakinetic enucleation of prostate combined with partitioned resection using Nesbit technique in treating BPH with huge volume

目的:探讨经尿道等离子分区剜除联合Nesbit电切术治疗巨大良性前列腺增生症的手术方法和应用价值。方法:自2015年5月~2017年2月,采用经尿道等离子分区剜除联合Nesbit电切术治疗36例前列腺体积超过100 ml的良性前列腺增生症患者,记录手术时间、术中出血量和住院时间,比较术前与术后1、3、6个月国际前列腺症状评分(IPSS)、生活质量(QOL)评分和最大尿流率(Q_(max))。结果:所有患者均顺利完成手术。手术时间(105.6±23.2)min、出血量(120.3±42.9)ml、无输血病例;无电切综合征(TURS)、无穿孔、无输尿管损伤等并发症发生。术后留置导尿管(3.5±1..2)d;住院时间(9 5±2.3)d。术后1、3、6个月IPSS、QOL、Q_(max)较术前均有明显改善(P<0.05)。4例拔尿管后出现轻度尿失禁,术后3个月均恢复。结论:经尿道等离子分区剜除联合Nesbit电切术治疗巨大良性前列腺增生症,切除腺体彻底,手术安全性高,并发症少,值得临床推广。

Objective: To explore the method and clinical value of transurethral plasmakinetic enucleation of prostate combined with partitioned resection using Nesbit technique in treating benigh prostatic hyperplasia(BPH)with huge volume. Methods: From May 2015 to February 2017, a total of 36 cases of BPH with huge volume greater than 100 mL were treated with transurethral plasmakinetic enucleation of prostate combined with partitioned resection using Nesbit technique at our institution and the clinical data were collected and analyzed. Results: All operations were successfully carried out. Operative time was(105. 6±23. 2)min. Estimated blood loss was(120. 3±42. 9)mL. There were no cases with transfusion, transurethral resection syndrome(TURS) or ureteral injury.Mean catheterization time was(3. 5±1. 2)days and hospital stay was(9. 5±2. 3)days. Patients had significant improved IPSS score, QOL score and Q_(max) one month after surgey(P<0. 05). Four patients, suffering from mild incontinence after catheter removal, were all recovered three months later. Conclusions: Transurethral plasmakinetic enucleation of prostate combined with partitioned resection using Nesbit technique was a safe and efficient surgical method in treating BPH with huge volume.