三沟逆切法直出绿激光前列腺汽化切除术治疗前列腺增生

摘要

目的 探讨三沟逆切法直出绿激光前列腺汽化切除术(photoselective vaporesection of the prostate,PVRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效及安全性.方法 回顾性分析2014年6月～2016年7月PVRP治疗BPH 167例资料,采用140 W直出绿激光手术系统,于前列腺颈部5点、7点、12点位置切三条沟,深至被膜直至精阜,连接三条深沟后由精阜逆行汽化切除前列腺组织.结果 手术时间(41.8±15.1)min,术中出血量(43.7±16.3)ml,术后膀胱冲洗时间(17.1±4.3)h,留置尿管时间(2.5±1.0)d.术后随访3～6个月,国际前列腺症状评分、生活质量评分、最大尿流率及残余尿量较术前均有明显改善.结论 绿激光三沟逆切法PVRP治疗BPH安全,快捷,有效.%Objective To discuss the safety and efficacy of "three-channel reverse section method"of straight light beam greenlight photoselective vaporesection of the prostate (PVRP) for the treatment of benign prostatic hyperplasia (BPH). Methods A retrospective analysis was performed in 167 patients with BPH undergoing "three-channel reverse section method"of straight light beam greenlight PVRP from June 2014 to July 2016.By using the 140 W straight light beam greenlight laser system , the operation began at the prostate neck with 3 incisions at the 5-, 7-and 12-o ' clock positions .The incisions were deepened until the surgical capsule was reached .After connecting the three deep ditches , reverse resection of prostate tissue from verumontanum was performed . Results The operation duration was (41.8 ±15.1) min, the blood loss was (43.7 ±16.3) ml, the postoperative irrigation time was (17.1 ±4.3) h, and the indwelling catheter time was (2.5 ±1.0) d.Follow-ups for 3-6 months showed significant improvement in the international prostate symptom score ( IPSS ) , quality of life score ( QOL ) , maximum urinary flow rate ( Qmax ) , and postvoid residual urine ( PVR) as compared with preoperation . Conclusion The "three-channel reverse section method"of straight light beam greenlight PVRP is safe and effective for BPH .