单一术者经尿道铥激光前列腺剜除术学习曲线分析

doi:10.19558/j.cnki.10-1020/r.2022.01.013

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摘要 目的： 了解单一术者采用经尿道铥激光前列腺剜除术（ThuLEP）治疗良性前列腺增生（BPH）的学习曲线。方法： 回顾性分析2020年1月至2021年4月北京大学第一医院泌尿外科一位泌尿外科医师开展的ThuLEP手术治疗BPH患者84例,依照接受手术先后顺序,均分为A、B、C三组,每组28例。比较三组患者t-PSA、前列腺体积、手术时间、前列腺剜除效率、导尿管留置时间、手术前后血红蛋白下降值、围术期并发症情况,进而分析采用ThuLEP术治疗BPH的学习曲线。结果： 三组患者手术时间和前列腺组织剜除效率差异有统计学意义（P<0.05）。相比C组,A、B两组的手术时间长[（83.21±22.61）vs. （60.57±23.56） min;（83.79±32.65）vs. （60.57±23.56） min],前列腺组织剜除效率低[0.51（0.34,0.70）vs. 0.94（0.59,1.25） ml/min ;0.47（0.34,0.75）vs. 0.94（0.59,1.25） ml/min],差异均具有统计学意义（P<0.05）。56例后操作者熟练掌握ThuLEP手术。结论： 采用ThuLEP术治疗BPH的医师可在56例后熟练掌握该手术,手术效率及安全性明显提高。

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	李志存
	车新艳
	张喆楠
	米悦
	杨昆霖
	张凯
	孟一森

关键词 ：前列腺增生, 铥激光, 前列腺剜除术, 学习曲线

Abstract：Objective： To investigate the learning curve of transurethral thulium laser enucleation of the prostate （ThuLEP） for benign prostatic hyperplasia （BPH） in a single surgeon. Methods： From January 2020 to April 2021, 84 patients with BPH undergoing ThuLEP surgery by a urologist in the Department of Urology of the First Hospital of Beijing University were retrospectively analyzed. According to the order of surgery, the patients were divided into three groups： A, B and C, with 28 patients in each group. t-PSA, prostate volume, operation time, prostate enucleation efficiency, catheter indwelling time, hemoglobin decrease before and after operation, perioperative complications were compared among the three groups, and the learning curve of BPH treated by ThuLEP was analyzed. Results： There were significant differences in operation time and prostate enucleation efficiency among the three groups （P<0.05）. Compared with group C, group A and groupB had longer operation time [（83.21±22.61）vs. （60.57±23.56）min;（83.79±32.65）vs. （60.57±23.56）min] and lower prostate enucleation efficiency [0.51（0.34,0.70）vs. 0.94（0.59,1.25）mL/min;0.47（0.34,0.75）vs. 0.94（0.59,1.25）mL/min], with statistically significant differences （P<0.05）. After surgeries of 56 cases, the operators were proficient in ThuLEP operation. Conclusion： Doctors who use ThuLEP to treat BPH can master the operation after surgeries of 56 cases, and the operation efficiency and safety are obviously improved.

Key words： benign prostatic hyperplasia thulium laser enucleation of the prostate learning curve

收稿日期: 2021-11-25

通讯作者: 孟一森,mgyss@qq.com

引用本文:

李志存, 车新艳, 张喆楠, 米悦, 杨昆霖, 张凯, 孟一森. 单一术者经尿道铥激光前列腺剜除术学习曲线分析[J]. 微创泌尿外科杂志, 2022, 11(1): 52-56.
Li Zhicun, Che Xinyan, Zhang Zhenan, Mi yue, Yang Kunlin, Zhang Kai, Meng Yisen. Thulium laser enucleation of the prostate: learning curve of single urologic doctor. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(1): 52-56.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1742.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2022/V11/I1/52

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