目的：热缺血时间对肾部分切除术后肾功能的影响仍然存在争议,探讨热缺血时间对肾部分切除术后长期肾功能的影响.方法：回顾性研究海德堡大学医学院泌尿外科1984年8月~2011年7月收治75名孤立肾患者实施的83例肾部分切除术,评估热缺血时...目的：热缺血时间对肾部分切除术后肾功能的影响仍然存在争议,探讨热缺血时间对肾部分切除术后长期肾功能的影响.方法：回顾性研究海德堡大学医学院泌尿外科1984年8月~2011年7月收治75名孤立肾患者实施的83例肾部分切除术,评估热缺血时间、术前肾功能基线水平、切除的正常肾组织体积对术后长期肾功能水平和变化的影响.结果：平均术前肾功能57.41 ml/mi n per 1.73 m2,平均热缺血时间为18.04 mi n ,平均切除的正常肾组织体积为18.79 c m3,平均随访时间69.39个月.多因素分析不同术前肾功能基线水平的各组在术后12个月时差异有统计学意义(P ＝0.01)；围手术期的急性肾衰竭事件明显而持续影响术后的肾功能水平(12个月 P ＝0.001,60个月 P ＝0.03)；而热缺血时间各分组和切除的正常肾组织体积与术后肾功能水平无关联.围手术期急性肾衰竭事件在术后12个月时明显影响术后肾功能的变化(P ＜0.01),切除的正常肾组织体积各组在整个随访期均保持显著差异(12个月 P ＝0.03,36个月 P ＜0.01,60个月 P ＜0.01).结论：术前肾脏质量和术后肾脏的体积是最重要的术后长期肾功能危险因素,术前肾功能基线水平决定术后肾功能的水平,术后存留的肾脏体积决定术后肾功能恢复的能力；围手术期急性肾衰竭事件是新发现的术后长期肾功能的风险因子；热缺血时间虽然与术后长期肾功能无直接关联,但可以通过增加围手术期急性肾衰竭事件的风险间接影响术后肾功能的水平和恢复能力.展开更多
We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal （TP） prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This w...We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal （TP） prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 （21.4%） of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy （with 95% scoring 〈5 in a 0-10 scale）. Twelve out of 196 men （6.1%） felt pain immediately after the procedure. Despite a high incidence of symptoms （e.g., up to 75% had some hematuria, 47% suffered some pain）, it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization （5.5%）. There were no inpatient admissions due to complications （hematuria, sepsis）. On repeat questioning at a later time point, only 25/199 （12.6%） of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.展开更多
文摘目的：热缺血时间对肾部分切除术后肾功能的影响仍然存在争议,探讨热缺血时间对肾部分切除术后长期肾功能的影响.方法：回顾性研究海德堡大学医学院泌尿外科1984年8月~2011年7月收治75名孤立肾患者实施的83例肾部分切除术,评估热缺血时间、术前肾功能基线水平、切除的正常肾组织体积对术后长期肾功能水平和变化的影响.结果：平均术前肾功能57.41 ml/mi n per 1.73 m2,平均热缺血时间为18.04 mi n ,平均切除的正常肾组织体积为18.79 c m3,平均随访时间69.39个月.多因素分析不同术前肾功能基线水平的各组在术后12个月时差异有统计学意义(P ＝0.01)；围手术期的急性肾衰竭事件明显而持续影响术后的肾功能水平(12个月 P ＝0.001,60个月 P ＝0.03)；而热缺血时间各分组和切除的正常肾组织体积与术后肾功能水平无关联.围手术期急性肾衰竭事件在术后12个月时明显影响术后肾功能的变化(P ＜0.01),切除的正常肾组织体积各组在整个随访期均保持显著差异(12个月 P ＝0.03,36个月 P ＜0.01,60个月 P ＜0.01).结论：术前肾脏质量和术后肾脏的体积是最重要的术后长期肾功能危险因素,术前肾功能基线水平决定术后肾功能的水平,术后存留的肾脏体积决定术后肾功能恢复的能力；围手术期急性肾衰竭事件是新发现的术后长期肾功能的风险因子；热缺血时间虽然与术后长期肾功能无直接关联,但可以通过增加围手术期急性肾衰竭事件的风险间接影响术后肾功能的水平和恢复能力.
文摘We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal （TP） prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 （21.4%） of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy （with 95% scoring 〈5 in a 0-10 scale）. Twelve out of 196 men （6.1%） felt pain immediately after the procedure. Despite a high incidence of symptoms （e.g., up to 75% had some hematuria, 47% suffered some pain）, it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization （5.5%）. There were no inpatient admissions due to complications （hematuria, sepsis）. On repeat questioning at a later time point, only 25/199 （12.6%） of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.
