机器人水刀前列腺消融术早期经验(附2例报告)

Early experience of Aquablation for Benign prostate hyperplasia:2 case reports

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摘要目的:报告机器人水刀前列腺消融术的技术经验及随访3个月的疗效。方法:2020年1月,中国人民解放军总医院第一医学中心率先在国内开展2例机器人水刀前列腺消融术,患者取截石位,于超声引导下规划切除范围,使用高压水束切除增生腺体,双极电凝止血;分析围手术期情况及术后3个月随访情况。结果:2例患者手术时间分别为65 min和45 min,水刀消融时间分别为2 min14 s和3 min28 s;术中估计出血量约20 mL和30mL;术后1例患者发生了Clavien-Dindo 3a级并发症(膀胱填塞),予以急诊手术处理;术后3个月2例患者的IPSS评分分别从27分下降到11分、从20分下降到5分;Q_(max)分别从6.1 mL/s增加到了17.9 mL/s;从3.2 mL/s增加到了9.1 mL/s。结论:机器人水刀消融技术是一项治疗BPH的新型外科治疗技术,但安全性及优越性有待大样本量对比性研究证实。 Objective:To describe the technique of aquablation in the treatment of benign prostate hyperplasia,and to report3-months functional outcomes.Methods:In January 2020,2 patients were undergone aquablation in our center,which was firstly reported in China.The key steps:place the patient in the lithotomy position;plan the resection area under ultrasound guidance;remove the hyperplastic glands with high-pressure water jets,and provide adequate hemostasis We report the perioperative conditions and follow-up outcomes at three months.Results:The operation time of the two patients was 65 minutes and 45 minutes respectively,and the ablation time was 134 seconds and208 seconds,respectively.Estimated intraoperative blood loss was 20 ml and 30 ml,respectively.One patient developed a clavien-dindo 3 a event(bladder tamper)during the perioperative period,which was treated by emergency surgery.At the 3 month of postoperative follow-up,the IPSS scores of the two patients decreased from 27 to 11 and 20 to 5,respectively,and Q_(max) increased from 6.1 mL/s to 17.9 mL/s and 3.2 mL/s to 9.1 mL/s,respectively.Conclusions:Aquablation is an alternative new surgical treatment for BPH.However,its safety and superiority need to be confirmed by comparative studies with large sample sizes.

作者朱捷王鹏超史涛坪符伟军宋勇郭刚王威李宏召马鑫张旭 ZHU Jie;WANG Pengchao;SHI Taoping;FU Weijun;SONG Yong;GUO Gang;WANG Wei;LI Hongzhao;MA Xin;ZHANG Xu(Department of Urology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Urology,Hainan Hospital of Chinese PLA General Hospital)

机构地区中国人民解放军总医院第一医学中心泌尿外科中国人民解放军总医院海南医院泌尿外科

出处《微创泌尿外科杂志》 2021年第5期326-330,共5页 Journal of Minimally Invasive Urology

关键词机器人水刀前列腺增生症消融术 robotic waterjet benign prostate hyperplasia ablation

分类号 R699.8 [医药卫生—泌尿科学]

作者简介通讯作者:张旭,xzhang@foxmail.com;共同第一作者:朱捷;共同第一作者:王鹏超