机器人水刀前列腺消融术早期经验（附2例报告）

doi:10.19558/j.cnki.10-1020/r.2021.05.008

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (2502 KB) RICH HTML
输出: BibTeX | EndNote (RIS)

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30 mL;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。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	朱捷
	王鹏超
	史涛坪
	符伟军
	宋勇
	郭刚
	王威
	李宏召
	马鑫
	张旭

关键词 ：机器人, 水刀, 前列腺增生症, 消融术

Abstract：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 and 208 seconds, respectively. Estimated intraoperative blood loss was 20ml and 30ml, respectively. One patient developed a clavien-dindo 3a 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.

Key words： robotic waterjet benign prostate hyperplasia ablation

收稿日期: 2020-05-11

通讯作者: 张旭,xzhang@foxmail.com

作者简介: ^*共同第一作者

引用本文:

朱捷, 王鹏超, 史涛坪, 符伟军, 宋勇, 郭刚, 王威, 李宏召, 马鑫, 张旭. 机器人水刀前列腺消融术早期经验（附2例报告）[J]. 微创泌尿外科杂志, 2021, 10(5): 326-330.
ZHU Jie, WANG Pengchao, SHI Taoping, FU Weijun, SONG Yong, GUO Gang, WANG Wei, LI Hongzhao, MA Xin, ZHANG Xu. Early experience of Aquablation for Benign prostate hyperplasia： 2 case reports. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(5): 326-330.

链接本文:

http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1705.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2021/V10/I5/326

[1] CHUGHTAI B, FORDE JC, THOMAS DD, et al.Benign prostatic hyperplasia. Nat Rev Dis Primers, 2016,2:16031.
[2] KAHOKEHR A, GILLING PJ.Landmarks in BPH--from aetiology to medical and surgical management.Nat Rev Urol, 2014,11(2):118-122.
[3] 董强,屈锐,柳良仁.前列腺增生症外科微创治疗.西部医学,2019,31(2):165-169.
[4] MISRAI V, RIJO E, ZORN KC, et al.Waterjet ablation therapy for treating benign prostatic obstruction in patients with small- to medium-size glands: 12-month results of the first French aquablation clinical registry. Eur Urol, 2019,76(5):667-675.
[5] DESAI M, BIDAIR M, ZORN KC, et al.Aquablation for benign prostatic hyperplasia in large prostates (80-150 mL): 6-month results from the WATER II trial. BJU Int, 2019,124(2):321-328.
[6] BHOJANI N, NGUYEN DD, KAUFMAN RJ, et al.Comparison of <?100 cc prostates and >?100 cc prostates undergoing aquablation for benign prostatic hyperplasia. World J Urol, 2019,37(7):1361-1368.
[7] NGUYEN DD, BHOJANI N, ZORN KC.Furthering the external validity of Aquablation and implications for real-world patients. World J Urol, 2019,37(9):1983-1984.
[8] GILLING P, REUTHER R, KAHOKEHR A, et al.Aquablation - image-guided robot-assisted waterjet ablation of the prostate: initial clinical experience. BJU Int, 2016,117(6):923-929.
[9] GILLING P, BARBER N, BIDAIR M, et al. WATER: A Double-Blind, Randomized, Controlled Trial of Aquablation® vs Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia. J Urol, 2016, 2018,199(5):1252-1261.
[10] BACH T, GILLING P, EL HAJJ A, et al.First Multi-Center All-Comers study for the aquablation procedure. J Clin Med, 2020,9(2):603.
[11] DESAI M, BIDAIR M, BHOJANI N, et al.WATER II (80-150 mL) procedural outcomes. BJU Int, 2019,123(1):106-112.
[12] PARSONS JK, DAHM P, KÖHLER TS, et al.Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline amendment 2020. J Urol, 2020,204(4):799-804.
[13] GRAVAS S, GACCI M, GRATZKE C, et al.Tikkinen Guidelines Associates:M. Karavitakis,I.Kyriazis,S. Malde,V. Sakalis,R. Umbach. EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms(LUTS),incl. Benign Prostatic Obstruction(BPO). Eur Urol Suppl, 2019:40-41.
[14] ROBERT G, CORNU JN, FOURMARIER M, et al. Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP). BJU Int, 2016,117(3):495-499.
[15] 刘正超. 经尿道前列腺剜除术治疗良性前列腺增生的应用进展.临床泌尿外科杂志,2020,35(5):409-412.
[16] MESKAWI M, HUEBER PA, VALDIVIESO R, et al.Multicenter international experience of 532 nm-laser photo-vaporization with Greenlight XPS in men with large prostates (prostate volume?>?100 cc). World J Urol, 2017,35(10):1603-1609.