Effects of irrigation fluid's absorption on 1 470nm diode laser enucleation versus vaporization for benign prostate hyperplasia

doi:10.3877/cma.j.issn.1674-3253.2018.04.015

Abstract

Abstract:

Objective

To investigate the effect of intraoperative absorption of irrigation fluid on the safety of transurethral vaporization of prostate (Di VAP) and enucleation of prostate (Di VEP) with 1470 nm semiconductor laser.

Methods

From July 2016 to February 2017, 40 patients with benign prostatic hyperplasia (BPH) admitted to our hospital were randomly divided into the Di VAP and Di VEP groups. The operation time, irrigation fluid volume, irrigation fluid absorption volume, postoperative persistent irrigation time of bladder, postoperative retention time of urinary catheter, postoperative length of hospital stay, hemoglobin, electrolyte, international prostate symptom score (IPSS), quality of life (QOL) score, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR) and postoperative complications were statistically compared between two groups.

Results

No statistical significance was noted in age, prostate volume, preoperative IPSS score, PVR, Qmax, mean operation time, irrigation fluid volume, postoperative persistent irrigation time of bladder, postoperative retention time of urinary catheter and postoperative length of hospital stay between two groups (all P>0.05). After corresponding surgery, the hemoglobin level in the Di VAP group was (1.9±1.0) g/L, significantly lower than (12.3±11.3) g/L in the Di VEP group (P=0.001). In the Di VAP group, irrigation fluid absorption was monitored in 3 cases with an average absorption volume of 675 (356-1 078) ml. In the Di VEP group, irrigation fluid absorption was observed in 10 cases with a mean absorption volume of 2 089 (187-7 240) ml with statistical significance between two groups (P<0.05). In both groups, the serum levels of K⁺ and Na⁺ did not significantly differ before and after surgery, whereas the hemoglobin level was significantly decreased (P<0.05). The IPSS, QOL, Qmax, PVR and the incidence of postoperative complications did not significantly differ between two groups.

Conclusion

Both Di VAP and Di VEP with 1 470 nm semiconductor laser are efficacious methods for the treatment of BPH, whereas Di VAP yields less irrigation fluid absorption and blood loss intraoperatively.

Key words: Prostatic hyperplasia, Prostatectomy, Irrigation fluid, Absorption

Fayou Zhou, Shuxian Zhang, Yajun Shen, Jiude Zheng. Effects of irrigation fluid's absorption on 1 470nm diode laser enucleation versus vaporization for benign prostate hyperplasia[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(04): 274-277.

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References 17

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组别	例数	年龄（岁）	PV（ml）	IPSS(分)	QOL（分）	Qmax（ml/s）	PVR（ml）
汽化组	20	70±10	65±38	25±4	4.8±0.7	8.9±3.5	137±105
剜除组	20	71±70	73±29	24±4	4.8±0.6	8.5±2.1	118±710
t值		-0.206	-1.029	0.310	0.237	0.448	0.635
P值		0.839	0.316	0.760	0.815	0.659	0.533

组别	例数	年龄（岁）	PV（ml）	IPSS(分)	QOL（分）	Qmax（ml/s）	PVR（ml）
汽化组	20	70±10	65±38	25±4	4.8±0.7	8.9±3.5	137±105
剜除组	20	71±70	73±29	24±4	4.8±0.6	8.5±2.1	118±710
t值		-0.206	-1.029	0.310	0.237	0.448	0.635
P值		0.839	0.316	0.760	0.815	0.659	0.533

组别	例数	手术时间（min）	灌注液使用量（L）	血红蛋白降低值（g/L）	血清Na⁺降低值（mmol/L）	血清K⁺降低值（mmol/L）	术后膀胱冲洗时间（h）	术后尿管停留时间（h）	术后住院时间（d）
汽化组	20	70±10	20±9	1.9±1.0	0.2±0.8	0.5±0.1	33±18	3.7±0.8	6.1±1.4
剜除组	20	71±7	17±9	12.3±11.3	0.4±2.6	0.6±0.3	30±13	3.8±0.7	5.9±0.8
统计值		t=-0.206	t=0.905	t=-3.900	t=-0.449	t=-0.097	t=0.677	t=-0.418	t=0.515
P值		0.839	0.377	0.001	0.658	0.924	0.506	0.681	0.612

组别	例数	手术时间（min）	灌注液使用量（L）	血红蛋白降低值（g/L）	血清Na⁺降低值（mmol/L）	血清K⁺降低值（mmol/L）	术后膀胱冲洗时间（h）	术后尿管停留时间（h）	术后住院时间（d）
汽化组	20	70±10	20±9	1.9±1.0	0.2±0.8	0.5±0.1	33±18	3.7±0.8	6.1±1.4
剜除组	20	71±7	17±9	12.3±11.3	0.4±2.6	0.6±0.3	30±13	3.8±0.7	5.9±0.8
统计值		t=-0.206	t=0.905	t=-3.900	t=-0.449	t=-0.097	t=0.677	t=-0.418	t=0.515
P值		0.839	0.377	0.001	0.658	0.924	0.506	0.681	0.612

组别	时间	例数	IPSS(分)	QOL（分）	Qmax（ml/s）	PVR（ml）
汽化组	术前	20	24.5±4.2	4.8±0.7	8.9±3.5	137±105
汽化组	术后3个月	20	119.6±2.3*	02.2±0.7*	18.9±3.9*	034±43
剜除组	术前	20	24.1±3.9	4.8±0.6	8.5±2.1	118±71
剜除组	术后3个月	20	010.0±2.4*	02.3±0.7*	19.5±4.0*	032±27
t值			-0.470	-0.400	-0.403	0.144
P值			0.644	0.694	0.691	0.887

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