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目的探讨腹腔镜治疗大体积良性前列腺增生症(BPH)的技术要点和临床疗效。方法大体积BPH患者12例,采用腹腔镜经膀胱前列腺剜除术。3例合并膀胱多发结石,结石直径2.5-4.6cm,2例伴有膀胱憩室。前列腺体积大于80ml。记录手术时间、术中出血量、术后膀胱冲洗时间,随访手术效果。结果 12例均一次手术成功,病理诊断BPH。同时处理结石和憩室。手术时间75-180min,术中出血80-360ml。术后膀胱冲洗0.5-3.0d,9-14d拔除导尿管。最大尿流率由(5.24±4.06)ml/s提高至(20.6±5.62)ml/s。术后无尿失禁、尿潴留或排尿困难等并发症发生。结论对大体积BPH患者行腹腔镜经膀胱前列腺剜除术具有创伤小、失血少、术后疼痛轻、住院时间短、疗效可靠等优点。
Objective To investigate the technical points and clinical efficacy of laparoscopic treatment of large-volume benign prostatic hyperplasia (BPH). Methods Large volume BPH patients in 12 cases, the use of laparoscopic transurethral resection of bladder. Three cases complicated with multiple bladder stones, stones diameter 2.5-4.6cm, 2 cases associated with bladder diverticulum. Prostate volume greater than 80ml. Record the operation time, intraoperative blood loss, postoperative bladder irrigation time, follow-up surgical results. Results All the 12 cases were successful in one operation and the pathological diagnosis was BPH. At the same time dealing with stones and diverticulum. Surgery time 75-180min, intraoperative bleeding 80-360ml. Postoperative bladder irrigation 0.5-3.0d, 9-14d catheter removed. The maximum urinary flow rate increased from (5.24 ± 4.06) ml / s to (20.6 ± 5.62) ml / s. Postoperative urinary incontinence, urinary retention or dysuria and other complications. Conclusions Laparoscopic transbronchial transurethral resection of prostate in small volume BPH patients has the advantages of less trauma, less blood loss, less postoperative pain, shorter hospitalization time and reliable curative effect.