CAJ | 학술논문

目的比较腹腔镜下耻骨后保留尿道前列腺切除术和经尿道前列腺电切术(TURP)治疗大体积前列腺增生的临床效果.方法回顾性分析128例大体积良性前列腺增生患者的临床资料及随访情况.其中行TURP患者72例(TURP组),行腹腔镜下耻骨后保留尿道前列腺切除术患者56例(腹腔镜组).比较两组的手术时间、术中出血量、切除腺体质量、膀胱冲洗时间、带管时间、住院时间、住院费用、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(MRF)、残余尿(RUV)等指标.结果腹腔镜组术后膀胱冲洗时间(0 d)、带管时间[(2.3±0.6)d]、住院时间[(4.2±0.5)d]均较TURP组[(2.8±1.2)、(5.2±1.5)、(7.5±0.5)d]少,切除腺体质量[(100.2±25.4)g]较TURP组[(85.6±15.5)g]多,组间比较差异有统计学意义(P＜0.05)；两组手术时间、术中出血量、住院费用比较差异无统计学意义(P＞0.05).两组术后3、6个月IPSS、QOL、RUV和MRF与术前比较差异均有统计学意义[腹腔镜组:(9.1±3.4)、(7.5±2.5)分比(27.5±5.8)分,(1.8±1.1)、(1.6±0.8)分比(5.5±0.5)分,( 26.5±11.5)、(22.4±12.6) ml比(145.0±48.0) ml,(17.6±8.4)、(20.2±5.4)ml/s比(8.3±3.5) ml/s;TURP组:(9.2±3.8)、(7.8±2.2)分比(28.5±5.4)分,(1.9±1.2)、(1.7±0.6)分比(5.0±0.5)分,(28.5±12.9)、(23.0±11.7) ml比(155.0±47.0) ml,(17.8±9.2)、(19.8±4.5) ml/s比(7.2±3.2) ml/s] (P＜ 0.01),但组间比较差异无统计学意义(P＞0.05).结论两种术式疗效均佳,行腹腔镜下耻骨后保留尿道前列腺切除术患者术后不需膀胱冲洗,带管时间短,住院时间少,恢复快.
목적 비교복강경하치골후보류뇨도전렬선절제술화경뇨도전렬선전절술(TURP)치료대체적전렬선증생적림상효과.방법 회고성분석128례대체적량성전렬선증생환자적림상자료급수방정황.기중행TURP환자72례(TURP조),행복강경하치골후보류뇨도전렬선절제술환자56례(복강경조).비교량조적수술시간、술중출혈량、절제선체질량、방광충세시간、대관시간、주원시간、주원비용、국제전렬선증상평분(IPSS)、생활질량평분(QOL)、최대뇨류솔(MRF)、잔여뇨(RUV)등지표.결과 복강경조술후방광충세시간(0 d)、대관시간[(2.3±0.6)d]、주원시간[(4.2±0.5)d]균교TURP조[(2.8±1.2)、(5.2±1.5)、(7.5±0.5)d]소,절제선체질량[(100.2±25.4)g]교TURP조[(85.6±15.5)g]다,조간비교차이유통계학의의(P＜0.05)；량조수술시간、술중출혈량、주원비용비교차이무통계학의의(P＞0.05).량조술후3、6개월IPSS、QOL、RUV화MRF여술전비교차이균유통계학의의[복강경조:(9.1±3.4)、(7.5±2.5)분비(27.5±5.8)분,(1.8±1.1)、(1.6±0.8)분비(5.5±0.5)분,( 26.5±11.5)、(22.4±12.6) ml비(145.0±48.0) ml,(17.6±8.4)、(20.2±5.4)ml/s비(8.3±3.5) ml/s;TURP조:(9.2±3.8)、(7.8±2.2)분비(28.5±5.4)분,(1.9±1.2)、(1.7±0.6)분비(5.0±0.5)분,(28.5±12.9)、(23.0±11.7) ml비(155.0±47.0) ml,(17.8±9.2)、(19.8±4.5) ml/s비(7.2±3.2) ml/s] (P＜ 0.01),단조간비교차이무통계학의의(P＞0.05).결론 량충술식료효균가,행복강경하치골후보류뇨도전렬선절제술환자술후불수방광충세,대관시간단,주원시간소,회복쾌.
Objective To compare the clinical effect between retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation and transurethral resection of the prostate (TURP) for giant benign prostatic hyperplasia (BPH).Methods The clinical data and follow-up of 128 cases of giant BPH were analyzed retrospectively.Seventy-two cases underwent TURP (TURP group) and 56 cases underwent retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation ( laparoscopic group ).The operation time,blood loss,gland mass excision,bladder washing time,catheterization time,hospital stay,hospital cost,international prostate symptoms score (IPSS) and quality of life questionnaires (QOL),maximum flow rate (MFR),residual urine volume (RUV) were compared between two groups.Results The bladder washing time,catheterization time,hospital stay in laparoscopic group were less than those in TURP group[0 d vs.(2.8 ± 1.2) d,(2.3 ± 0.6) d vs.(5.2 ± 1.5) d,(4.2 ± 0.5) d vs.(7.5 ±0.5) d],gland mass excision in laparoscopic group was more than that in TURP group [(100.2 ±25.4) g vs.(85.6 ± 15.5) g],there were significant differences between two groups(P＜ 0.05).There was no significant difference in the operation time,blood loss,hospital cost between two groups (P ＞ 0.05).There were significant differences in IPSS,QOL,RUV and MRF before and after 3,6 months treatment for two groups [ laparoscopic group:(9.1 ± 3.4),(7.5 ± 2.5 ) scores vs.(27.5 ± 5.8) scores,( 1.8 ± 1.1 ),( 1.6 ± 0.8)scores vs. (5.5 t0.5) scores,(26.5 ± 11.5),(22.4 ± 12.6) ml vs. (145.0 ±48.0) ml,(17.6 ±8.4),(20.2 ± 5.4) ml/s vs.(8.3 ± 3.5) ml/s;TURP group:(9.2 ± 3.8),(7.8 ± 2.2) scores vs.(28.5 ± 5.4) scores,( 1.9 ± 1.2),( 1.7 ± 0.6) scores vs.(5.0 ± 0.5 ) scores,(28.5 ± 12.9),(23.0 ± 11.7) ml vs. ( 155.0 ± 47.0) ml,( 17.8 ± 9.2),( 19.8 ± 4.5 ) ml/s vs.(7.2 ± 3.2 ) ml/s ] (P ＜ 0.01 ),but there was no significant difference between two groups (P ＞ 0.05).Conclusions The clinical effect of two microtrauma surgery are good.Laparoscopic technique is a feasible treatment option for patients suffered from giant BPH for which has the benefit of a quicker recovery,shorter hospital stay,less complications,no bladder washing.