Первый опыт биполярных трансуретральных операций в хирургии доброкачественной гиперплазии простаты
DOI:
https://doi.org/10.25726/NM.2019.71.95.002Ключевые слова:
доброкачественная гиперплазия предстательной железы, биполярная трансуретральная резекция и энуклеация простаты, хирургия, методы, простата, пациентыАннотация
Представлены результаты внедрения в хирургическую практику урологического отделения Дорожной клинической больницы г. Ярославль биполярной техники трансуретральной резекции (БТУР) и энуклеации простаты (ТУЭБ) для лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) средних и больших размеров.
В сравнительное исследование включено 164 пациента, разделенных по методам операции на 2 основные группы (ТУЭБ - 33 человека, БТУР - 49) и 2 контрольные (открытая простатэктомия - ОПЭ - 38 и монополярная ТУР - 44). Для новых эндоскопических методов установлено значимое снижение объема кровопотери, частоты геморрагических осложнений, сроков послеоперационной катетеризации и госпитализации. Для количественной оценки различий средних и относительных показателей использо-вали непараметрический критерий Манна-Уитни, оценка качественных признаков проводилась с применением критерия Пирсона (χ2), уровень значимости различий для исследования выбран р ≤ 0,05.
Анализ послеоперационной динамики клинических показателей в среднесрочной перспективе показал сходную радикальность и эффектив-ность сравниваемых методов.
Установленные меньшая инвазивность, большая безопасность и лучшая переносимость биполярных эндоскопических операций демонстрируют перспективность их внедрения взамен бывших стандартных хирургических методов, что позволит повысить качество оперативного лечения и сократить затраты стационара.
Библиографические ссылки
1. Apolikhin O.I., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Semenychev D.V., Kochkin A.D. (2013). Dinamika i prognozy zabolevaemosti dobrokachestvennoj giperplaziej predstatel'noj zhelezy v Nizhegorodskoj oblasti [Dynamics and forecasts of the incidence of benign prostatic hyperplasia in the Nizhny Novgorod region]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology], 3, 4-7. (In Russ.)
2. Apolikhin O.I., Sivkov A.V., Zolotukhin O.V., Shaderkin I.A., Voitko D.A., Prosyannikov M.Yu., Ivanov V.M., Golovanov S.A., Katibov M.I. (2018). Rasprostranennost' simptomov narushenija funkcii nizhnih mochevyh putej u muzhchin po rezul'tatam populjacionnogo issledovanija [The prevalence of symptoms of impaired lower urinary tract function in men according to a population study]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology],1, 4-12. (In Russ.)
3. da Silva R.D., Bidikov L., Michaels W. et al. (2015). Bipolar energy in the treatment of benign prostatic hyperplasia: a current systematic review of the literature. Can J Urol, 22 Suppl 1, 30-44.
4. Danilov VV, Osinkin KS, Danilov VV, Sevryukov F.A. (2018). Al'fa1-adrenoblokatory i giperaktivnost' detruzora u pacientov s adenomoj predstatel'noj zhelezy [Alpha1-blockers and detrusor hyperactivity in patients with prostate adenoma]. Voprosy urologii i andrologii [Questions of urology and andrology], 6(2), 49-53.
5. Foo K.T. (2019). What is a disease? What is the disease clinical benign prostatic hyperplasia (BPH)? // World J Urol, Feb. 25, pp 1–4.
6. Geavlete B, Stanescu F, Iacoboaie C, Geavlete P. (2013). Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases - A medium term, prospective, randomized comparison. BJU Int. May, 111(5), 793–803.
7. Gilling P. (2014). TURP remains a safe and effective alternative for benign prostatic hyperplasia (BPH) surgery. BJU Int., 113(1), 5–6.
8. Ilchenko, G.V., Ishchenko O.Y., Linova E.N. (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.
9. Kahokehr A., Gilling P.J. (2014). Enucleation techniques for benign prostate obstruction: which one and why? Current Opinion in Urology, 24(1), 49–55.
10. 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.)
11. 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.)
12. 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.)
13. Kamyshov S.V., Pulatov D.A., Yuldasheva N.S. (2017). Ispol'zovanie metodov gravitacionnoj hirurgii krovi v kompleksnom lechenii bol'nyh rakom jaichnika [The use of methods of gravitational blood surgery in the complex treatment of patients with ovarian cancer]. Vestnik Nacional'nogo mediko-hirurgicheskogo centra im. N.I. Pirogova [Bulletin of the National medical and surgical center after N. I. Pirogova], 12(1), 52–56. (In Russ.)
14. Khamurzaev S.Sh., Kulikova N.G. (2013). Puti snizhenija invalidnosti u lic trudosposobnogo vozrasta [Ways of decreasing disability in persons of working age]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and medical history], 6, 29–31. (In Russ.)
15. Kulikova N.G. (2004). Pervichnaja profilaktika oslozhnennyh involjucionno-vozrastnyh disreguljacij u lic starshe 40 let [Primary prevention of complicated involution-age dysregulations in persons older than 40 years]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and medical history], 5, 27–28. (In Russ.)
16. Li M., Qiu J., Hou Q. et al. (2015). Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. PLoS One, 10(3), e0121265.
17. 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.
18. Luo Y.-H., Shen J.-H., Guan R.-Y., Li H., Wang J. (2014). Plasmakinetic enucleation of the prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: comparison of outcomes according to prostate size in 310 patients. Urol, 84(4), 904–910.
19. Mark S., Roger K., Scott D., Chris I. (2015). Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - Focus on the UK. BJU International, 115(4), 508–519.
20. Pulatov D.A., Ibragimov J.M., Kamyshov S.V. (2017). Sravnitel'naja ocenka toksichnosti lechenija bol'nyh himiorezistentnym kolorektal'nym rakom [Comparative assessment of toxicity of treatment of patients with chemoresistant colorectal cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2(44), 58–61. (In Russ.)
21. Rao J.-M., Xiao H.-J., Ren Y.-X. et al. (2014). Did prostate size affect the complication and outcome of plasmakinetic enucleation of the prostate? International Urology and Nephrology, 46(11), 2063–2070.
22. Rao J.-M., Yang J.-R., Ren Y.-X., He J., Ding P., Yang J.-H. (2013). Plasmakinetic enucleation of the prostate versus transvesical open prostatectomy for benign prostatic hyperplasia >80 mL: 12-month follow-up results of a randomized clinical trial. Urol., 82, 176–181.
23. Salalykina E.V. Papikyan O.A. (2018). Optimization of the nursing staff in the Central regional hospital [Voprosy optimizacii raboty srednego medicinskogo personala v uslovijah central'noj rajonnoj bol'nicy]. International Journal of Medicine and Psychology, 1(2), 12–16.
24. 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.)
25. Semenychev D.V., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Kochkin A.D. (2014). Opyt primenenija bipoljarnoj vaporezekcii predstatel'noj zhelezy (TUVRB) v lechenii DGPZh [Experience with the use of bipolar vapor resection of the prostate gland (TUVRB) in the treatment of BPH]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology], 2, 49-53. (In Russ.)
26. Sevryukov F.A. (2012). Metodika prognozirovanija rezul'tatov transuretral'noj jenukleacii predstatel'noj zhelezy bol'shih razmerov [The method for predicting the results of transurethral enucleation of the prostate gland of large sizes]. Moskovskij hirurgicheskij zhurnal [Moscow Surgical Journal], 3 (25), 38-42. (In Russ.)
27. Sevryukov F.A. (2012). Kachestvo zhizni bol'nyh posle transuretral'noj jenukleacii adenomy predstatel'noj zhelezy bol'shih razmerov [The quality of life of patients after transurethral enucleation of large prostate adenomas]. Andrologija i genital'naja hirurgija [Andrology and genital surgery], 13(3), 42-46. (In Russ.)
28. Sevryukov F.A., Kamaev I.A., Mushroom M.N., Perevezentsev E.A., Malinina O.Yu., Elina Yu.A. (2011). Faktory riska i kachestvo zhizni bol'nyh s dobrokachestvennoj giperplaziej predstatel'noj zhelezy [Risk factors and quality of life in patients with benign prostatic hyperplasia]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald], 3, 48-52. (In Russ.)
29. Stucki P., Marini L., Mattei A., Xafis K., Boldini M., Danuser H. (2015). Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized trial focusing on bleeding complications. J Urol, 193(4), 1371–1376.
30. Zhang K.-Y., Xing J.-C., Chen B.-S., Liu C.-X., Lau H.-W., Sim H.-G., Foo K.-T. (2011). Bipolar plasmakinetic transurethral resection of the prostate vs. transurethral enucleation and resection of the prostate: pre- and postoperative comparisons of parameters used in assessing benign prostatic enlargement. Singap Med J., 52(10), 747–775.
2. Apolikhin O.I., Sivkov A.V., Zolotukhin O.V., Shaderkin I.A., Voitko D.A., Prosyannikov M.Yu., Ivanov V.M., Golovanov S.A., Katibov M.I. (2018). Rasprostranennost' simptomov narushenija funkcii nizhnih mochevyh putej u muzhchin po rezul'tatam populjacionnogo issledovanija [The prevalence of symptoms of impaired lower urinary tract function in men according to a population study]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology],1, 4-12. (In Russ.)
3. da Silva R.D., Bidikov L., Michaels W. et al. (2015). Bipolar energy in the treatment of benign prostatic hyperplasia: a current systematic review of the literature. Can J Urol, 22 Suppl 1, 30-44.
4. Danilov VV, Osinkin KS, Danilov VV, Sevryukov F.A. (2018). Al'fa1-adrenoblokatory i giperaktivnost' detruzora u pacientov s adenomoj predstatel'noj zhelezy [Alpha1-blockers and detrusor hyperactivity in patients with prostate adenoma]. Voprosy urologii i andrologii [Questions of urology and andrology], 6(2), 49-53.
5. Foo K.T. (2019). What is a disease? What is the disease clinical benign prostatic hyperplasia (BPH)? // World J Urol, Feb. 25, pp 1–4.
6. Geavlete B, Stanescu F, Iacoboaie C, Geavlete P. (2013). Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases - A medium term, prospective, randomized comparison. BJU Int. May, 111(5), 793–803.
7. Gilling P. (2014). TURP remains a safe and effective alternative for benign prostatic hyperplasia (BPH) surgery. BJU Int., 113(1), 5–6.
8. Ilchenko, G.V., Ishchenko O.Y., Linova E.N. (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.
9. Kahokehr A., Gilling P.J. (2014). Enucleation techniques for benign prostate obstruction: which one and why? Current Opinion in Urology, 24(1), 49–55.
10. 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.)
11. 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.)
12. 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.)
13. Kamyshov S.V., Pulatov D.A., Yuldasheva N.S. (2017). Ispol'zovanie metodov gravitacionnoj hirurgii krovi v kompleksnom lechenii bol'nyh rakom jaichnika [The use of methods of gravitational blood surgery in the complex treatment of patients with ovarian cancer]. Vestnik Nacional'nogo mediko-hirurgicheskogo centra im. N.I. Pirogova [Bulletin of the National medical and surgical center after N. I. Pirogova], 12(1), 52–56. (In Russ.)
14. Khamurzaev S.Sh., Kulikova N.G. (2013). Puti snizhenija invalidnosti u lic trudosposobnogo vozrasta [Ways of decreasing disability in persons of working age]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and medical history], 6, 29–31. (In Russ.)
15. Kulikova N.G. (2004). Pervichnaja profilaktika oslozhnennyh involjucionno-vozrastnyh disreguljacij u lic starshe 40 let [Primary prevention of complicated involution-age dysregulations in persons older than 40 years]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and medical history], 5, 27–28. (In Russ.)
16. Li M., Qiu J., Hou Q. et al. (2015). Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. PLoS One, 10(3), e0121265.
17. 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.
18. Luo Y.-H., Shen J.-H., Guan R.-Y., Li H., Wang J. (2014). Plasmakinetic enucleation of the prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: comparison of outcomes according to prostate size in 310 patients. Urol, 84(4), 904–910.
19. Mark S., Roger K., Scott D., Chris I. (2015). Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - Focus on the UK. BJU International, 115(4), 508–519.
20. Pulatov D.A., Ibragimov J.M., Kamyshov S.V. (2017). Sravnitel'naja ocenka toksichnosti lechenija bol'nyh himiorezistentnym kolorektal'nym rakom [Comparative assessment of toxicity of treatment of patients with chemoresistant colorectal cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2(44), 58–61. (In Russ.)
21. Rao J.-M., Xiao H.-J., Ren Y.-X. et al. (2014). Did prostate size affect the complication and outcome of plasmakinetic enucleation of the prostate? International Urology and Nephrology, 46(11), 2063–2070.
22. Rao J.-M., Yang J.-R., Ren Y.-X., He J., Ding P., Yang J.-H. (2013). Plasmakinetic enucleation of the prostate versus transvesical open prostatectomy for benign prostatic hyperplasia >80 mL: 12-month follow-up results of a randomized clinical trial. Urol., 82, 176–181.
23. Salalykina E.V. Papikyan O.A. (2018). Optimization of the nursing staff in the Central regional hospital [Voprosy optimizacii raboty srednego medicinskogo personala v uslovijah central'noj rajonnoj bol'nicy]. International Journal of Medicine and Psychology, 1(2), 12–16.
24. 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.)
25. Semenychev D.V., Sevryukov F.A., Sorokin D.A., Karpukhin I.V., Puchkin A.B., Kochkin A.D. (2014). Opyt primenenija bipoljarnoj vaporezekcii predstatel'noj zhelezy (TUVRB) v lechenii DGPZh [Experience with the use of bipolar vapor resection of the prostate gland (TUVRB) in the treatment of BPH]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology], 2, 49-53. (In Russ.)
26. Sevryukov F.A. (2012). Metodika prognozirovanija rezul'tatov transuretral'noj jenukleacii predstatel'noj zhelezy bol'shih razmerov [The method for predicting the results of transurethral enucleation of the prostate gland of large sizes]. Moskovskij hirurgicheskij zhurnal [Moscow Surgical Journal], 3 (25), 38-42. (In Russ.)
27. Sevryukov F.A. (2012). Kachestvo zhizni bol'nyh posle transuretral'noj jenukleacii adenomy predstatel'noj zhelezy bol'shih razmerov [The quality of life of patients after transurethral enucleation of large prostate adenomas]. Andrologija i genital'naja hirurgija [Andrology and genital surgery], 13(3), 42-46. (In Russ.)
28. Sevryukov F.A., Kamaev I.A., Mushroom M.N., Perevezentsev E.A., Malinina O.Yu., Elina Yu.A. (2011). Faktory riska i kachestvo zhizni bol'nyh s dobrokachestvennoj giperplaziej predstatel'noj zhelezy [Risk factors and quality of life in patients with benign prostatic hyperplasia]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald], 3, 48-52. (In Russ.)
29. Stucki P., Marini L., Mattei A., Xafis K., Boldini M., Danuser H. (2015). Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized trial focusing on bleeding complications. J Urol, 193(4), 1371–1376.
30. Zhang K.-Y., Xing J.-C., Chen B.-S., Liu C.-X., Lau H.-W., Sim H.-G., Foo K.-T. (2011). Bipolar plasmakinetic transurethral resection of the prostate vs. transurethral enucleation and resection of the prostate: pre- and postoperative comparisons of parameters used in assessing benign prostatic enlargement. Singap Med J., 52(10), 747–775.
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Опубликован
2018-12-25
Как цитировать
Glotov, N. A., Sokolov, N. E., & Smolyakov, Y. B. (2018). Первый опыт биполярных трансуретральных операций в хирургии доброкачественной гиперплазии простаты. Вопросы экологии, 8(4), 10–20. https://doi.org/10.25726/NM.2019.71.95.002
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