Transurethral Photoselective Vaporization of the Prostate with Large-Volume Benign Prostate Hyperplasia_West China Medical Journal

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Unit of Urology and Transplantation, Department of Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu, Sichuan 610072, P.R.China;

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Keywords：

激光手术; 前列腺摘除术; 绿激光; 疗效

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【摘要】目的 总结80 W绿激光汽化术治疗大体积良性前列腺增生症的技术及临床疗效。方法回顾性分析2007年9月-2009年11月完成经尿道80 W绿激光汽化术治疗体积 gt;100 mL良性前列腺增生症患者围手术期及随访资料，包括术前前列腺体积、血红蛋白、国际前列腺症状评分（IPSS）、生活质量（QOL）评分，手术时间、汽化激光能量及术后血清钠、血红蛋白、术后留置尿管时间、IPSS、QOL评分、3个月后残余前列腺体积等。结果 45例体积 gt;100 mL的良性前列腺增生症患者均在持续硬膜外麻醉下完成手术，无中转开放手术。术前前列腺体积（128.82±24.82） mL，血红蛋白（138.5±6.85） g/mL，IPSS评分27.10±2.88，QOL 4.26±0.87，术前最大尿流率（6.53±3.76） mL/s，手术时间（141.00±30.19） min，汽化能量（36.14±11.64） MJ，术后3 d血红蛋白（124.33±7.64） g/mL，术后留置尿管时间（101.55±20.55） h，术前与术后血清钠无明显变化，血红蛋白轻度下降，无需输血。3个月后残余前列腺体积（44.63±10.31） mL，IPSS评分11.58±2.52，QOL 2.74±1.10。无尿道狭窄发生。结论经尿道80 W 绿激光汽化术治疗体积 gt;100 mL的良性前列腺增生症，具有良好的安全性和临床疗效，可作为此类患者的首选治疗之一。
【Abstract】 Objective To investigate the efficacy and safety of 80 Watt high-power potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate (PVP) in patients with large-volume benign prostate hyperplasia ( gt;100 mL). Methods Retrospective analysis was performed in patients with large-volume benign prostatic hyperplasia ( gt;100 mL), who were treated with the 80 Watt KTP transurethral photoselective laser vaporization of the prostate from September 2007 to November 2009. The preoperative evaluation included prostate volume by transrectal ultrasonic scanning, serum sodium and serum hemoglobin, international prostate symptom score (IPSS) and quality of life (QOL) score. The operative time and vaporization energy and average indwelling catheterization time were recorded. The postoperative serum sodium, serum hemoglobin after the operation were compared with those before the operation. After 3 months, the IPSS, QOL and residual prostate volume were evaluated. Results Forty-five patients of totally 219 patients with gt;100 mL prostate in volume were successfully operated under continuous epidural anesthesia. None was changed to open operation. The mean preoperative prostate volume was (128.82±24.82) mL, the mean IPSS was (27.10±2.88) and QOL were (4.26±0.87). The mean operative time was (141.00±30.19) minutes. The mean indwelling catheterization was (102.17±19.50) hours. The serum sodium did not change, while the serum hemoglobin level reduced mildly but without transfusion. After 3 month, the mean IPSS was (11.58±2.52) and QOL were (2.74±1.10) with residual prostate volume was (44.63±10.31) mL. No stricture was observed in 〖LM〗this group. Conclusion The transurethral photoselective vaporization of the prostate with 80 Watt KTP laser is a safe and effective therapy for patients with gt;100 mL prostate in volume in experienced PVP center.

Citation： XIONG Wei,RAN Qing,DOU Ke,DENG Xiaofan,YANG Hongji,DI Wenjia. Transurethral Photoselective Vaporization of the Prostate with Large-Volume Benign Prostate Hyperplasia. West China Medical Journal, 2010, 25(9): 1615-1617. doi: Copy

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3.	Chung DE, Te AE. New techniques for laser prostatectomy: an update [J]. Ther Adv in Urol, 2009, 1(2): 85-97.
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6.	Ruszat R, Seitz M, Wyler SF, et al. GreenLight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures[J]. Eur Urol, 2008, 54(4): 893-901.
7.	Spaliviero M, Araki M, Culkin DJ, et al. Incidence, management, and prevention of perioperative complications of GreenLight HPS laser photoselective vaporization prostatectomy: experience in the first 70 patients [J]. J Endourol, 2009, 23(3): 495-502.

1. Van Cleynenbreugel B, Srirangam SJ, Van Poppel H. High-performance system GreenLight laser: indications and outcomes[J]. Curr Opin Urol, 2009, 19(1): 33-37.
2. Rajbabu K, Chandrasekara SK, Barber NJ, et al. Photoselective vaporization of the prostate with the potassium-titanyl-phosphate laser in men with prostates of >100 mL[J]. BJU Int, 2007, 100(3): 593-598.
3. Chung DE, Te AE. New techniques for laser prostatectomy: an update [J]. Ther Adv in Urol, 2009, 1(2): 85-97.
4. 钟景琦, 金讯波, 赵勇, 等. 80 W KTP激光汽化术治疗大体积前列腺增生的临床应用[J]. 中国男科学杂志, 2008, 22(3): 36-38, 41.
5. 李逊, 徐桂彬, 何永忠, 等. 选择性绿激光汽化术治疗重度前列腺增生患者的临床分析[J]. 中华腔镜泌尿外科杂志, 2009, 3(1): 7-9.
6. Ruszat R, Seitz M, Wyler SF, et al. GreenLight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures[J]. Eur Urol, 2008, 54(4): 893-901.
7. Spaliviero M, Araki M, Culkin DJ, et al. Incidence, management, and prevention of perioperative complications of GreenLight HPS laser photoselective vaporization prostatectomy: experience in the first 70 patients [J]. J Endourol, 2009, 23(3): 495-502.

West China Medical Journal

Transurethral Photoselective Vaporization of the Prostate with Large-Volume Benign Prostate Hyperplasia

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