经腹膜外腹腔镜下前列腺剜除术治疗大体积前列腺增生(附15例报告)

Extraperitoneal laparoscopic enucleation in the treatment of BPH with large prostate volume (15 cases report)

目的:探讨腹腔镜技术在大腺体前列腺增生手术中的应用。方法:回顾性分析2015年8月~2016年4月接受经腹膜外腹腔镜下前列腺剜除术的15例患者资料,对其手术方法进行总结分析,并记录手术时间、术中出血量、切除前列腺重量、留置尿管时间、住院时间,比较术前和术后3个月的IPSS评分、MFR的差异,评价手术效果。结果:15例患者手术均获成功,无一例中转行开放手术。手术时间(112.6±26.8)min,手术出血量(110.4±39.6)ml,切除前列腺重量(102.7±21.3)g,留置尿管时间(7.8±0.5)d,术后住院时间(10.6±0.6)d。术后3个月患者IPSS评分(5.8±1.6)分,MFR(18.6±2.7)ml/s,与术前相比差异有统计学意义(P<0.05)。结论:腹腔镜手术治疗大腺体前列腺增生具有安全、彻底、疗效好的优点,是一项可行并值得推广的技术。

Objective:To explore the application of laparoscopic technique in the treatment of benign prostatic hyperplasia(BPH)with large prostate volume.Methods:Fifteen BPH patients in our hospital were reviewed from August 2015 to April 2016.All patients underwent extraperitoneal laparoscopic enucleation of the prostate,and the surgical methods were summarized.The operative time,surgical blood loss,weight of the prostate resected,indwelling catheter time and hospital stay were recorded.The differences in IPSS score and maximum urinary flow rate(MFR)before and 3 months after operation were compared,and the effect of operation was evaluated.Results:The operative procedures for all 15 patients were successful,without any requirement for open surgery.Surgical time was(112.6±26.8)min,the operative blood loss was(110.4±39.6)mL,the weight of the prostate resected was(102.7±21.3)g,indwelling catheter time was(7.8±0.5)d,and the postoperative hospital stay was(10.6±0.6)d.Three months after operation,the IPSS score was(5.8±1.6)and the MFR was(18.6±2.7)mL/s,which were significantly different from those preoperation(P <0.05).Conclusions:Laparoscopic surgery for the treatment of large gland BPH has the advantages of safety,thoroughness and good curative effect,which is a feasible technology worthy of promotion.