Estudio comparativo de adenomectomía prostática laparoscópica y abierta. ¿Cuál ofrece mejores resultados?

Q4 Medicine
V.M. Pérez Manzanares , F. Salinas González , R.A. García Vásquez , J. Arriaga Aguilar , M.C. Candia Plata
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引用次数: 1

Abstract

Background

Standard management of benign prostatic hyperplasia in large volume adenomas is open surgery. With the advent a little over a decade ago of minimally invasive techniques for prostatic adenoma, this trend is changing.

Aim

Given that there are few comparative studies establishing a real difference between open and laparoscopic surgery, the aim of our study was to objectively evaluate their advantages.

Methods

A total of 82 patients were analyzed. They were diagnosed with benign prostatic hyperplasia and were consecutively operated upon. Twenty-four of the patients underwent laparoscopic surgery and 58 had open surgery.

Results

There was significant difference in relation to patient weight (<0.001), which was greater in the laparoscopic adenomectomy group (LA). The two groups had similar results in regard to preoperative studies such as PSA, IPSS, prostate size, and uroflowmetry. The surgical indications were also similar and the most frequent indication was acute urinary retention. Surgery duration was longer in the LA group with statistical significance (127.2 vs. 90.9 min; P≤0.001) and intraoperative blood loss and transfusions were significantly lower in the LA group, based on the Clavien-Dindo classification (450 vs. 738.8 ml; P=0.009 and 0.45 vs. 0.25; P=0.039, respectively). There were no differences between the two procedures in relation to length of hospital stay, postoperative results, or complications (according to the Clavien-Dindo classification).

Conclusions

Both procedures had similar postoperative results and complications, but there was less blood loss and fewer transfusions with the laparoscopic procedure. Surgery duration was longer with the laparoscopic technique and there were no differences in relation to hospital stay.

腹腔镜前列腺腺切除术与开放式前列腺腺切除术的比较研究。哪一个效果最好?
背景:大容量腺瘤良性前列腺增生的标准治疗方法是开放手术。随着十多年前前列腺腺瘤微创技术的出现,这一趋势正在改变。考虑到目前很少有比较研究能够确定开放手术和腹腔镜手术之间的真正区别,我们研究的目的是客观地评价它们的优势。方法对82例患者的临床资料进行分析。确诊为良性前列腺增生,均行手术治疗。24例患者行腹腔镜手术,58例行开放手术。结果两组患者体重差异有统计学意义(<0.001),其中腹腔镜腺瘤切除术组(LA)差异更大。两组在术前研究如PSA、IPSS、前列腺大小和尿流测量方面的结果相似。手术指征也相似,最常见的指征是急性尿潴留。LA组手术时间更长,差异有统计学意义(127.2 vs 90.9 min;P≤0.001),根据Clavien-Dindo分类,LA组术中失血量和输血量显著降低(450 vs. 738.8 ml;P=0.009和0.45 vs. 0.25;分别为P = 0.039)。两种手术在住院时间、术后结果或并发症(根据Clavien-Dindo分类)方面没有差异。结论两种手术的术后结果和并发症相似,但腹腔镜手术的出血量和输血量更少。腹腔镜技术的手术时间更长,与住院时间没有差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Revista mexicana de urologia
Revista mexicana de urologia Medicine-Urology
CiteScore
0.20
自引率
0.00%
发文量
49
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.
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