F. Delgado-Guerrero , L.M. Covarrubias-Méndez , A. González-Gómez , J. Bernal-Hernández , J. Torres-Aguilar , R. Arellano-Cuadros
{"title":"Experiencia de adenomectomía prostática laparoscópica","authors":"F. Delgado-Guerrero , L.M. Covarrubias-Méndez , A. González-Gómez , J. Bernal-Hernández , J. Torres-Aguilar , R. Arellano-Cuadros","doi":"10.1016/j.uromx.2015.11.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Up to the present, transurethral resection of the prostate has been recognized as the standard surgical treatment for prostatic growth. The first report of a laparoscopic procedure for the management of prostatic growth was in 2002, when Dr. Mariano Mirandolino published an anecdotal case of laparoscopic prostatic adenomectomy (LPA) in Brazil. Since then 19 studies have been published reporting on the experience with this laparoscopic technique. The procedure was begun at our hospital in mid-2010.</p></div><div><h3>Aim</h3><p>The aim of the present study was to describe the experience with LPA at our hospital, along with the characteristics of the patients that underwent the procedure.</p></div><div><h3>Material and methods</h3><p>Patients that underwent LPA within the time frame of 2010 to December 2014 were included in the study. Preoperative characteristics, intraoperative findings, and postoperative results were documented.</p></div><div><h3>Results</h3><p>A total of 58 patients were included. The median age was 66 years (range: 46 to 85 years). Twelve patients presented with chronic degenerative diseases. Mean surgery duration was 148.6<!--> <!-->min with a range of 90 to 240<!--> <!-->min, and mean blood loss was 228.56<!--> <!-->ml, with a median of 400<!--> <!-->ml. The mean weight of the extracted adenomas was 118<!--> <!-->±<!--> <!-->34<!--> <!-->g. The postoperative means were: hospital stay, 2.7 days, time with a transurethral Foley catheter, 7.79 days, and time with a Penrose drain in the space of Retzius, 6.4 days. Follow-up was carried out in outpatient consultation for a mean 4.2 months, and IPSS questionnaires were applied one month after surgery, showing a mean improvement of 15 points (<em>P</em> <!--><<!--> <!-->.001). In relation to postoperative complications (9%), acute urinary retention due to bladder clots presented the day after the procedure.</p></div><div><h3>Conclusions</h3><p>LPA is an alternative procedure to transurethral resection of the prostate that shows good functional results and a low complication rate.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2015.11.003","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista mexicana de urologia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2007408515001433","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
Abstract
Background
Up to the present, transurethral resection of the prostate has been recognized as the standard surgical treatment for prostatic growth. The first report of a laparoscopic procedure for the management of prostatic growth was in 2002, when Dr. Mariano Mirandolino published an anecdotal case of laparoscopic prostatic adenomectomy (LPA) in Brazil. Since then 19 studies have been published reporting on the experience with this laparoscopic technique. The procedure was begun at our hospital in mid-2010.
Aim
The aim of the present study was to describe the experience with LPA at our hospital, along with the characteristics of the patients that underwent the procedure.
Material and methods
Patients that underwent LPA within the time frame of 2010 to December 2014 were included in the study. Preoperative characteristics, intraoperative findings, and postoperative results were documented.
Results
A total of 58 patients were included. The median age was 66 years (range: 46 to 85 years). Twelve patients presented with chronic degenerative diseases. Mean surgery duration was 148.6 min with a range of 90 to 240 min, and mean blood loss was 228.56 ml, with a median of 400 ml. The mean weight of the extracted adenomas was 118 ± 34 g. The postoperative means were: hospital stay, 2.7 days, time with a transurethral Foley catheter, 7.79 days, and time with a Penrose drain in the space of Retzius, 6.4 days. Follow-up was carried out in outpatient consultation for a mean 4.2 months, and IPSS questionnaires were applied one month after surgery, showing a mean improvement of 15 points (P < .001). In relation to postoperative complications (9%), acute urinary retention due to bladder clots presented the day after the procedure.
Conclusions
LPA is an alternative procedure to transurethral resection of the prostate that shows good functional results and a low complication rate.
期刊介绍:
Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.