Оценка среднесрочных результатов биполярной трансуретральной резекции в лечении доброкачественной гиперплазии простаты
DOI:
https://doi.org/10.25726/NM.2019.77.26.001Ключевые слова:
доброкачественная гиперплазия предстательной железы, биполярная трансуретральная резекция простаты, кровопотеря, осложнение, затраты на лечение, госпитализацияАннотация
Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений.
Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов.
Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию.
Библиографические ссылки
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10. Sevryukov F.A., Kamaev I.A., Mushroom M.N., Perevezentsev E.A. (2011). Osnovnye aspekty obespechenija vysokokvalificirovannoj urologicheskoj medicinskoj pomoshh'ju bol'nyh s dobrokachestvennoj giperplaziej predstatel'noj zhelezy [The main aspects of providing highly qualified urological medical care to patients with benign prostatic hyperplasia]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald], 19 (1), 109-113. (In Russ.)
11. Sevryukov F.A., Kamaev I.A., Malinina O.Yu., Mushroom M.N., Perevezentsev E.A. (2011). Social'nyj status pacientov, stradajushhih dobrokachestvennoj giperplaziej predstatel'noj zhelezy [The social status of patients suffering from benign prostatic hyperplasia]. Obshhestvennoe zdorov'e i zdravoohranenie [Public health and healthcare], 1, 53-56. (In Russ.)
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13. Sevryukov F.A. (2012). Transuretral'naja rezekcija v fiziologicheskom rastvore [Transurethral resection in saline]. Urologija [Urology], 2, 67-70. (In Russ.)
14. Semenychev D.V., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Kochkin A.D., Knutov A.V. (2015). Sravnitel'naja ocenka bipoljarnoj transuretral'noj vaporezekcii (TUVRB) i bipoljarnoj rezekcii (TURIS) v lechenii dobrokachestvennoj giperplazii prostaty [Comparative evaluation of bipolar transurethral vapor resection (TUVRB) and bipolar resection (TURIS) in the treatment of benign prostatic hyperplasia]. Medicinskij vestnik Bashkortostana [Medical Bulletin of Bashkortostan], 10 (3), 16-19. (In Russ.)
15. Semenychev D.V., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Kochkin A.D., Knutov A.V. (2017). Sravnitel'naja ocenka jeffektivnosti razlichnyh jenergeticheskih blokov v bipoljarnoj hirurgii prostaty [Comparative evaluation of the effectiveness of various energy blocks in bipolar prostate surgery]. Tihookeanskij medicinskij zhurnal [Pacific Medical Journal], 1 (67), 88-90. (In Russ.)
16. Sitdykov E.N., Zubkov A.Yu., Zubkov E.A. (2004). Vybor metoda lechenija bol'nyh s adenomoj predstatel'noj zhelezy [The choice of treatment for patients with prostate adenoma]. Kazanskij med. Zhurnal [Kazan Med. Magazine], 85(5), 356-359. (In Russ.)
17. Sitdykov E.N. (2004). Obstruktivnye oslozhnenija operativnogo lechenija DGPZh [Obstructive complications of surgical treatment of BPH]. Kazanskij med. Zhurnal [Kazan Med. Magazine], 5, 356–359. (In Russ.)
18. Sorokin D.A., Sevryukov F.A., Semenychev D.V., Karpukhin I.V., Puchkin A.B., Kochkin A.D., Knutov A.V. (2015). Rezul'taty primenenija gialuronovoj kisloty posle transuretral'nyh jendoskopicheskih operacij po povodu dobrokachestvennoj giperplazii prostaty [The results of the use of hyaluronic acid after transurethral endoscopic surgery for benign prostatic hyperplasia]. Medicinskij vestnik Bashkortostana [Medical Bulletin of Bashkortostan], 10 (3), 19-24. (In Russ.)
19. Tkachuk V.N. (2004). Sovremennye predstavlenija ob jetiologii i patogeneze dobrokachestvennoj giperplazii predstatel'noj zhelezy [Modern ideas about the etiology and pathogenesis of benign prostatic hyperplasia]. Nefrologija [Nephrology], 8(2), 90-93. (In Russ.)
20. Bruschini H., Simonetti R., Antunes A. A., Srougi M. (2011). Urinary incontinence following surgery for BPH: the role of aging on the incidence of bladder dysfunction. Int. Brazilian J. Urol., 37(3), 380–387.
21. Chen S., Zhu L., Cai J., et al. (2014). Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than 100 grams: a randomized noninferiority controlled trial with long-term results at 6 years. Eur Urol., 66 (2), 284–291.
22. Liu C., Zheng S., Li H., Xu K. (2010). Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol., 184 (6), 2440-2445.
23. Parsons J.K., Kashefi C. (2008). Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. Eur Urol., 53, 1228-1235.
24. Patel N.D., Parsons J.K. (2014). Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian J Urol., 30 (2), 170-176.
25. Kamyshov S.V., Pulatov D.A., Nishanov D.A., Yuldasheva N.Sh., Yusupova N.B. (2017). Znachimost' ocenki molekuljarno-biologicheskih onkomarkerov v soprovoditel'noj immunoterapii pri rake shejki matki [Significance of evaluation of molecular biological tumor markers in accompanying immunotherapy in cervical cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2, 45-48. (In Russ.)
26. Salalykina E.V., Jablonka N.V. (2018). Aspekty organizacii raboty srednego medicinskogo personala otdelenija medicinskogo centra [Aspects of organization of work of paramedical personnel Department of the medical center]. International Journal of Medicine and Psychology, 1(4), 19-23. (In Russ.)
27. Kamyshov S.V., Nishanov D.A., Pulatov D.A., Yuldasheva N.S. (2017). Izuchenie markerov apoptoza, proliferacii i angiogeneza u bol'nyh rakom jaichnika, poluchivshih soprovoditel'nuju immunoterapiju [Study of markers of apoptosis, proliferation and angiogenesis in patients with ovarian cancer who received accompanying immunotherapy]. Zlokachestvennye opuholi [Malignant tumors], 1, 84–91. (In Russ.)
28. Ilchenko G. V., Ishchenko O. Yu., Lynova E.N., Prischep L.V. (2018). Ocenka organizacionnoj lojal'nosti v medicinskih uchrezhdenijah [Assessment of organizational loyalty in medical institutions]. International Journal of Medicine and Psychology, 1(4), 24-35. (In Russ.)
2. Gorilovsky L.M., Zingerenko M.B. (2011). Posleoperacionnye oslozhnenija transuretral'noj rezekcii prostaty [Postoperative complications of transurethral resection of the prostate]. Klinicheskaja gerontologija [Clinical Gerontology], 9, 3-7. (In Russ.)
3. Kalininskaya A.A., Mashin A.G., Sevryukov F.A. (2013). Faktory riska razvitija giperplazii predstatel'noj zhelezy [Risk factors for developing prostatic hyperplasia]. Social'nye aspekty zdorov'ja naselenija [Social aspects of public health], 29 (1), 1-9. (In Russ.)
4. Kalininskaya A.A., Sevryukov F.A. (2012). Sovremennye vozmozhnosti transuretral'noj jelektrorezekcii v fiziologicheskom rastvore v lechenii zabolevanij nizhnih mochevyh putej i prostaty [Modern possibilities of transurethral electroresection in physiological saline in the treatment of diseases of the lower urinary tract and prostate]. Mezhdunarodnyj zhurnal jeksperimental'nogo obrazovanija [International Journal of Experimental Education], 6, 41-43. (In Russ.)
5. Kamalov A.A., Gushchin B.L., Dorofeev S.D. [and etc.]. (2004). Sovremennye aspekty operativnogo lechenija dobrokachestvennoj giperplazii predstatel'noj zhelezy [Modern aspects of surgical treatment of benign prostatic hyperplasia]. Urologija [Urology], 1, 30-34. (In Russ.)
6. Kamalov A.A., Sevryukov F.A. (2012). Izuchenie jeffektivnosti bipoljarnoj transuretral'noj rezekcii adenomy prostaty srednih i malyh razmerov [Study of the effectiveness of bipolar transurethral resection of adenomas of the prostate of medium and small sizes]. Sovremennye tehnologii v medicine [Modern technologies in medicine], 4, 68-72. (In Russ.)
7. Lopatkin N.A. (2011). Transuretral'nye operacii na prostate. Oslozhnenija transuretral'noj rezekcii prostaty [Transurethral surgery on the prostate. Complications of transurethral resection of the prostate]. Urologija. Nacional'noe rukovodstvo [Urology. National leadership]. Moscow, GEOTAR-Media, 190–195. (In Russ.)
8. Markov A.V., Lukyanov I.V., Laurent O.B. (2007). Kompleksnaja terapija irritativnyh rasstrojstv mocheispuskanija posle transuretral'noj rezekcii prostaty i adenomjektomii [Combination therapy of irritative urination disorders after transurethral resection of the prostate and adenomectomy]. Urologija [Urology], 4, 41–44. (In Russ.)
9. Martov A.G., Merinov D.S., Kornienko S.I. [and etc.]. (2006). Posleoperacionnye urologicheskie oslozhnenija transuretral'nyh jelektrohirurgicheskih vmeshatel'stv na predstatel'noj zheleze po povodu adenomy [Postoperative urological complications of transurethral electrosurgical interventions on the prostate gland due to adenoma]. Urologija [Urology], 2, 25-31. (In Russ.)
10. Sevryukov F.A., Kamaev I.A., Mushroom M.N., Perevezentsev E.A. (2011). Osnovnye aspekty obespechenija vysokokvalificirovannoj urologicheskoj medicinskoj pomoshh'ju bol'nyh s dobrokachestvennoj giperplaziej predstatel'noj zhelezy [The main aspects of providing highly qualified urological medical care to patients with benign prostatic hyperplasia]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald], 19 (1), 109-113. (In Russ.)
11. Sevryukov F.A., Kamaev I.A., Malinina O.Yu., Mushroom M.N., Perevezentsev E.A. (2011). Social'nyj status pacientov, stradajushhih dobrokachestvennoj giperplaziej predstatel'noj zhelezy [The social status of patients suffering from benign prostatic hyperplasia]. Obshhestvennoe zdorov'e i zdravoohranenie [Public health and healthcare], 1, 53-56. (In Russ.)
12. Sevryukov F.A., Malinina O.Yu. (2012). Novye organizacionnye tehnologii okazanija medicinskoj pomoshhi bol'nym s dobrokachestvennoj giperplaziej predstatel'noj zhelezy [New organizational technologies for providing medical care to patients with benign prostatic hyperplasia]. Social'nye aspekty zdorov'ja naselenija [Social aspects of public health], 23 (1), 5. (In Russ.)
13. Sevryukov F.A. (2012). Transuretral'naja rezekcija v fiziologicheskom rastvore [Transurethral resection in saline]. Urologija [Urology], 2, 67-70. (In Russ.)
14. Semenychev D.V., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Kochkin A.D., Knutov A.V. (2015). Sravnitel'naja ocenka bipoljarnoj transuretral'noj vaporezekcii (TUVRB) i bipoljarnoj rezekcii (TURIS) v lechenii dobrokachestvennoj giperplazii prostaty [Comparative evaluation of bipolar transurethral vapor resection (TUVRB) and bipolar resection (TURIS) in the treatment of benign prostatic hyperplasia]. Medicinskij vestnik Bashkortostana [Medical Bulletin of Bashkortostan], 10 (3), 16-19. (In Russ.)
15. Semenychev D.V., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Kochkin A.D., Knutov A.V. (2017). Sravnitel'naja ocenka jeffektivnosti razlichnyh jenergeticheskih blokov v bipoljarnoj hirurgii prostaty [Comparative evaluation of the effectiveness of various energy blocks in bipolar prostate surgery]. Tihookeanskij medicinskij zhurnal [Pacific Medical Journal], 1 (67), 88-90. (In Russ.)
16. Sitdykov E.N., Zubkov A.Yu., Zubkov E.A. (2004). Vybor metoda lechenija bol'nyh s adenomoj predstatel'noj zhelezy [The choice of treatment for patients with prostate adenoma]. Kazanskij med. Zhurnal [Kazan Med. Magazine], 85(5), 356-359. (In Russ.)
17. Sitdykov E.N. (2004). Obstruktivnye oslozhnenija operativnogo lechenija DGPZh [Obstructive complications of surgical treatment of BPH]. Kazanskij med. Zhurnal [Kazan Med. Magazine], 5, 356–359. (In Russ.)
18. Sorokin D.A., Sevryukov F.A., Semenychev D.V., Karpukhin I.V., Puchkin A.B., Kochkin A.D., Knutov A.V. (2015). Rezul'taty primenenija gialuronovoj kisloty posle transuretral'nyh jendoskopicheskih operacij po povodu dobrokachestvennoj giperplazii prostaty [The results of the use of hyaluronic acid after transurethral endoscopic surgery for benign prostatic hyperplasia]. Medicinskij vestnik Bashkortostana [Medical Bulletin of Bashkortostan], 10 (3), 19-24. (In Russ.)
19. Tkachuk V.N. (2004). Sovremennye predstavlenija ob jetiologii i patogeneze dobrokachestvennoj giperplazii predstatel'noj zhelezy [Modern ideas about the etiology and pathogenesis of benign prostatic hyperplasia]. Nefrologija [Nephrology], 8(2), 90-93. (In Russ.)
20. Bruschini H., Simonetti R., Antunes A. A., Srougi M. (2011). Urinary incontinence following surgery for BPH: the role of aging on the incidence of bladder dysfunction. Int. Brazilian J. Urol., 37(3), 380–387.
21. Chen S., Zhu L., Cai J., et al. (2014). Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than 100 grams: a randomized noninferiority controlled trial with long-term results at 6 years. Eur Urol., 66 (2), 284–291.
22. Liu C., Zheng S., Li H., Xu K. (2010). Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol., 184 (6), 2440-2445.
23. Parsons J.K., Kashefi C. (2008). Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms. Eur Urol., 53, 1228-1235.
24. Patel N.D., Parsons J.K. (2014). Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian J Urol., 30 (2), 170-176.
25. Kamyshov S.V., Pulatov D.A., Nishanov D.A., Yuldasheva N.Sh., Yusupova N.B. (2017). Znachimost' ocenki molekuljarno-biologicheskih onkomarkerov v soprovoditel'noj immunoterapii pri rake shejki matki [Significance of evaluation of molecular biological tumor markers in accompanying immunotherapy in cervical cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2, 45-48. (In Russ.)
26. Salalykina E.V., Jablonka N.V. (2018). Aspekty organizacii raboty srednego medicinskogo personala otdelenija medicinskogo centra [Aspects of organization of work of paramedical personnel Department of the medical center]. International Journal of Medicine and Psychology, 1(4), 19-23. (In Russ.)
27. Kamyshov S.V., Nishanov D.A., Pulatov D.A., Yuldasheva N.S. (2017). Izuchenie markerov apoptoza, proliferacii i angiogeneza u bol'nyh rakom jaichnika, poluchivshih soprovoditel'nuju immunoterapiju [Study of markers of apoptosis, proliferation and angiogenesis in patients with ovarian cancer who received accompanying immunotherapy]. Zlokachestvennye opuholi [Malignant tumors], 1, 84–91. (In Russ.)
28. Ilchenko G. V., Ishchenko O. Yu., Lynova E.N., Prischep L.V. (2018). Ocenka organizacionnoj lojal'nosti v medicinskih uchrezhdenijah [Assessment of organizational loyalty in medical institutions]. International Journal of Medicine and Psychology, 1(4), 24-35. (In Russ.)
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Опубликован
2018-12-15
Как цитировать
Vekilyan, A. S., & Gluhov, A. G. (2018). Оценка среднесрочных результатов биполярной трансуретральной резекции в лечении доброкачественной гиперплазии простаты. Вопросы экологии, 8(4), 1–9. https://doi.org/10.25726/NM.2019.77.26.001
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