高龄高危病人经耻骨上前列腺摘除术110例分析

目的:回顾分析110例高龄高危前列腺增生症(BPH)病人经耻骨上前列腺摘除的可行性和围手术期治疗,以探讨提高开放手术的安全性及成功率的经验。方法:本组BPH病例均术前进行实际病情及手术危险性评估,治疗合并症,采用耻骨上前列腺切除术治疗。结果:除2例术后因出血需再次手术外,其余均安全度过围手术期,无死亡病例。术后平均随访12个月,排尿通畅。术后所有病例的最大尿流率(Qm ax)>15 mL/s。结论:经耻骨上前列腺切除术能切除全部增生的腺体组织,能同时处理膀胱内并发病灶,较适合于III度以上的BPH患者。只要严格掌握手术适应证,加强围手术期的处理,开放手术治疗是可行的。

Analysis of 110 old patients with high risk undergone suprapubic prostatectomy

Aim: To evaluate the feasibility of suprapubic prostatedtomy and the perioperative experience of the treatment of benign prostatic hyperplasia(BPH) in order to increase success and security of the open operation.Methods: All the patients were treated with suprapubic transvesical prostatectomy(SPP) after we evaluate the state of the illness and the risk of the operation and deal with the complications.Results: One handred and ten cpatients were reviewed.Only two patients required secondary surgical treatment.The others survived the perioperative period safely and were cured by the operation.All the patients' postoperative average maximal uriuary flow rate(Q_(max)) was over 15 mL/s.Conclusion: All the proliferative tissue of prostate can be cut off by SPP,which can eliminate the complication of bladder at the same time.It is suitable to the III BPH.Mastering the surgical indications strictly and improving perioperative management are the keys to success operation.