Преимущества биполярной трансуретральной энуклеации при лечении доброкачественной гиперплазии простаты крупных размеров
DOI:
https://doi.org/10.25726/NM.2019.22.46.003Ключевые слова:
доброкачественная гиперплазия предстательной железы, биполярная трансуретральная энуклеация простаты, открытая операция, оперативное лечение, лечение, осложнения.Аннотация
Представлена оценка среднесрочных клинических результатов внедрения биполярной техники выполнения трансуретральной энуклеации (ТУЭБ) доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом свыше 80 см3.
Исследование проведено на базе урологического отделения «Дорожной клинической больницы на станции Воронеж-1 ОАО «РЖД» города Воронежа, где применение метода ТУЭБ для хирургического лечения ДГПЖ началось с 2016г. В исследование включено 67 пациентов (основная группа), оперированных методом ТУЭБ, и 79 – методом открытой чреспузырной простатэктомии (ОПЭ, контрольная группа). Применение ТУЭБ позволило в 3 раза сократить срок послеоперационной катетеризации и в 2 раза - объем кровопотери во время операции и общий срок госпитализации. При этом количество операционных осложнений было достоверно меньшим в сравнении с ОЧПЭ, а показатели эффективности оперативного лечения статистически равные.
Полученные результаты позволили рекомендовать метод ТУЭБ к широкому применению в урологических клиниках в качестве стандарта хирургического лечения ДГПЖ крупных размеров. Эндоскопический аналог открытой операции следует активно внедрять в хирургическую практику лечения ДГПЖ, что позволит снизить инвазивность оперативного лечения за счет уменьшения риска развития массивных кровотечений и многих других осложнений, а также повысить эффективность использования профильного коечного фонда и экономить средства стационара за счет сокращения продолжительности госпитализации.
Библиографические ссылки
1. Al-Shukri S.Kh., Tkachuk I.N. (2008). Profilaktika irritativnyh rasstrojstv mocheispuskanija posle transuretral'noj rezekcii prostaty u bol'nyh dobrokachestvennoj giperplaziej predstatel'noj zhelezy [Prevention of irritative urination disorders after transurethral resection of the prostate in patients with benign prostatic hyperplasia]. Nefrologija [Nephrology], 12(4), 67-71. (In Russ.)
2. Gordeev V.V., Antonov A.G., Pisarenko M.Yu., Marshev S.V., Masaltseva N.A. (2016). Bipoljarnaja transuretral'naja rezekcija v fiziologicheskom rastvore pri oslozhnennyh formah dobrokachestvchennoj giperplazii predstatel'noj zhelezy [Bipolar transurethral resection in physiological saline in complicated forms of benign prostatic hyperplasia]. Tihookeanskij medicinskij zhurnal [Pacific Medical Journal], 1, 79-81. (In Russ.)
3. Ivashchenko V.A., Dyusyubaev A.A. (2013). Diagnostika i medikamentoznaja korrekcija simptomov nizhnih mochevyh putej posle TUR dobrokachestvennoj giperplazii predstatel'noj zhelezy [Diagnosis and drug correction of lower urinary tract symptoms after TUR of benign prostatic hyperplasia]. Medicinskij vestnik Bashkortostana [Medical Bulletin of Bashkortostan], 8(2), 62-66. (In Russ.)
4. Kamyshov S.V., Nishanov D.A., Pulatov D.A., Yuldasheva N.Sh. (2017). Izuchenie markerov apoptoza, proliferacii i angiogeneza u bol'nyh rakom jaichnika, poluchivshih soprovoditel'nuju immunoterapiju [The 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.)
5. Kamyshov S.V., Pulatov D.A., Yuldasheva N.Sh. (2017). Ispol'zovanie metodov gravitacionnoj hirurgii krovi v kompleksnom lechenii bol'nyh rakom jaichnika [The use of gravitational blood surgery methods 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. Pirogov], 12(1), 52-56. (In Russ.)
6. Kamyshov S.V., Yuldasheva N.Sh., Salimova L.R. (2010). Vozmozhnosti ispol'zovanija jekstrakorporal'noj immunofarmakoterapii v kombinirovannom lechenii raka shejki matki [Possibilities of using extracorporeal immunopharmacotherapy in the combined treatment of cervical cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 3-4 (16-17), 95-96. (In Russ.)
7. Kulikova N.G. (2004). Pervichnaja profilaktika oslozhnennyh involjucionno-vozrastnyh disreguljacij u lic starshe 40 let [Primary prevention of complicated age-related involuntary dysregulation in people over 40 years of age]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, healthcare and the history of medicine], 5, 27-28. (In Russ.)
8. Lokshin K.L., Tangriberganov M.R., Gadzhieva Z.K. (2012). Sovremennye vozmozhnosti medikamentoznoj terapii pri sohranenii irritativnyh simptomov posle TUR DGPZh. Jeffektivnaja farmakoterapija [Modern possibilities of drug therapy while maintaining irritative symptoms after TUR of BPH. Effective pharmacotherapy]. Urologija i nefrologija [Urology and Nephrology], 1, 24-27. (In Russ.)
9. 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.)
10. 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.)
11. Sevryukov F.A. (2012). Transuretral'naja rezekcija v fiziologicheskom rastvore [Transurethral resection in saline]. Urologija [Urology], 2, 67-70. (In Russ.)
12. Sevryukov F.A., Kamaev I.A., Malinina O.Yu., Elina Yu.A., Mushroom M.N., Perevezentsev E.A. (2011). Vozrastnye osobennosti zabolevaemosti muzhchin boleznjami mochepolovoj sistemy [Age-related features of the incidence of diseases of the genitourinary system in men]. Medicinskij al'manah [Medical almanac], 4 (17), 21-23. (In Russ.)
13. Sevryukov F.A., Kochkin A.D., Sorokin D.A., Semenychev D.V., Knutov A.V. (2015). Bipoljarnaja transuretral'naja jenukleacija gigantskoj adenomy prostaty [Bipolar transurethral enucleation of giant prostate adenoma]. Tihookeanskij medicinskij zhurnal [Pacific Medical Journal], 4 (62), 72-74. (In Russ.)
14. 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.)
15. Sevryukov F.A., Serebryany S.A. (2012). Sluchaj uspeshnoj transuretral'noj jenukleacii adenomy prostaty ochen' bol'shih razmerov [A case of successful transurethral enucleation of prostate adenoma is very large]. Andrologija i genital'naja hirurgija [Andrology and genital surgery], 13(3), 101-103. (In Russ.)
16. 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.)
17. 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.)
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. Tarasov N.I., Ivashchenko V.A. (2016). Lechenie rasstrojstv mocheispuskanija posle transuretral'noj rezekcii predstatel'noj zhelezy [Treatment of urinary disorders after transurethral resection of the prostate gland]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology], 1, 98-105. (In Russ.)
20. Alyaev Yu.G., Glybochko P.V., Pushkar D.Yu. (eds). (2016). Urologija. Rossijskie klinicheskie rekomendacii [Urology. Russian Clinical Recommendations]. Moscow, GEOTARMEDIA, 496. (In Russ.)
21. Khamurzoeva S.Sh., Kulikova N.G. (2013). Puti snizhenija invalidnosti u lic trudosposobnogo vozrasta [Ways to reduce disability in people of working age]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and the history of medicine], 6, 29-31. (In Russ.)
22. Yaroshenko V.P., Miller A.M. (2011). Irritativnye rasstrojstva mocheispuskanija posle transuretral'noj jelektrorezekcii u bol'nyh dobrokachestvennoj giperplaziej predstatel'noj zhelezy. Jeffektivnaja farmakoterapija [Irritative urination disorders after transurethral electroresection in patients with benign prostatic hyperplasia. Effective pharmacotherapy]. Urologija i nefrologija [Urology and Nephrology], 1, 27-28. (In Russ.)
23. Chen S, Zhu L, Cai J, Zheng Z, Ge R, Wu M, 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, 284-291.
24. 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.
25. Kaplan S.A. (2016). Re: EAU Guidelines on the Assessment of Non-Neurogenic Male Lower Urinary Tract Symptoms Including Benign Prostatic Obstruction. J Urol, 196(6), 1712-1714.
26. 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.
27. Nakagava K. (2007). A new minimally invasive medical treatment for prostatic hyperplasia: its current situation and actual practice of the operation; TUEB. Urology View, 5, 95-97.
28. Ou R.B., Deng X.R., Yang W.J., Wei X.H., Chen H., Xie K.J. (2013). Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes > 80mL: a prospective randomized study. BJU Int., 112, 239-245.
2. Gordeev V.V., Antonov A.G., Pisarenko M.Yu., Marshev S.V., Masaltseva N.A. (2016). Bipoljarnaja transuretral'naja rezekcija v fiziologicheskom rastvore pri oslozhnennyh formah dobrokachestvchennoj giperplazii predstatel'noj zhelezy [Bipolar transurethral resection in physiological saline in complicated forms of benign prostatic hyperplasia]. Tihookeanskij medicinskij zhurnal [Pacific Medical Journal], 1, 79-81. (In Russ.)
3. Ivashchenko V.A., Dyusyubaev A.A. (2013). Diagnostika i medikamentoznaja korrekcija simptomov nizhnih mochevyh putej posle TUR dobrokachestvennoj giperplazii predstatel'noj zhelezy [Diagnosis and drug correction of lower urinary tract symptoms after TUR of benign prostatic hyperplasia]. Medicinskij vestnik Bashkortostana [Medical Bulletin of Bashkortostan], 8(2), 62-66. (In Russ.)
4. Kamyshov S.V., Nishanov D.A., Pulatov D.A., Yuldasheva N.Sh. (2017). Izuchenie markerov apoptoza, proliferacii i angiogeneza u bol'nyh rakom jaichnika, poluchivshih soprovoditel'nuju immunoterapiju [The 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.)
5. Kamyshov S.V., Pulatov D.A., Yuldasheva N.Sh. (2017). Ispol'zovanie metodov gravitacionnoj hirurgii krovi v kompleksnom lechenii bol'nyh rakom jaichnika [The use of gravitational blood surgery methods 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. Pirogov], 12(1), 52-56. (In Russ.)
6. Kamyshov S.V., Yuldasheva N.Sh., Salimova L.R. (2010). Vozmozhnosti ispol'zovanija jekstrakorporal'noj immunofarmakoterapii v kombinirovannom lechenii raka shejki matki [Possibilities of using extracorporeal immunopharmacotherapy in the combined treatment of cervical cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 3-4 (16-17), 95-96. (In Russ.)
7. Kulikova N.G. (2004). Pervichnaja profilaktika oslozhnennyh involjucionno-vozrastnyh disreguljacij u lic starshe 40 let [Primary prevention of complicated age-related involuntary dysregulation in people over 40 years of age]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, healthcare and the history of medicine], 5, 27-28. (In Russ.)
8. Lokshin K.L., Tangriberganov M.R., Gadzhieva Z.K. (2012). Sovremennye vozmozhnosti medikamentoznoj terapii pri sohranenii irritativnyh simptomov posle TUR DGPZh. Jeffektivnaja farmakoterapija [Modern possibilities of drug therapy while maintaining irritative symptoms after TUR of BPH. Effective pharmacotherapy]. Urologija i nefrologija [Urology and Nephrology], 1, 24-27. (In Russ.)
9. 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.)
10. 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.)
11. Sevryukov F.A. (2012). Transuretral'naja rezekcija v fiziologicheskom rastvore [Transurethral resection in saline]. Urologija [Urology], 2, 67-70. (In Russ.)
12. Sevryukov F.A., Kamaev I.A., Malinina O.Yu., Elina Yu.A., Mushroom M.N., Perevezentsev E.A. (2011). Vozrastnye osobennosti zabolevaemosti muzhchin boleznjami mochepolovoj sistemy [Age-related features of the incidence of diseases of the genitourinary system in men]. Medicinskij al'manah [Medical almanac], 4 (17), 21-23. (In Russ.)
13. Sevryukov F.A., Kochkin A.D., Sorokin D.A., Semenychev D.V., Knutov A.V. (2015). Bipoljarnaja transuretral'naja jenukleacija gigantskoj adenomy prostaty [Bipolar transurethral enucleation of giant prostate adenoma]. Tihookeanskij medicinskij zhurnal [Pacific Medical Journal], 4 (62), 72-74. (In Russ.)
14. 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.)
15. Sevryukov F.A., Serebryany S.A. (2012). Sluchaj uspeshnoj transuretral'noj jenukleacii adenomy prostaty ochen' bol'shih razmerov [A case of successful transurethral enucleation of prostate adenoma is very large]. Andrologija i genital'naja hirurgija [Andrology and genital surgery], 13(3), 101-103. (In Russ.)
16. 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.)
17. 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.)
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. Tarasov N.I., Ivashchenko V.A. (2016). Lechenie rasstrojstv mocheispuskanija posle transuretral'noj rezekcii predstatel'noj zhelezy [Treatment of urinary disorders after transurethral resection of the prostate gland]. Jeksperimental'naja i klinicheskaja urologija [Experimental and clinical urology], 1, 98-105. (In Russ.)
20. Alyaev Yu.G., Glybochko P.V., Pushkar D.Yu. (eds). (2016). Urologija. Rossijskie klinicheskie rekomendacii [Urology. Russian Clinical Recommendations]. Moscow, GEOTARMEDIA, 496. (In Russ.)
21. Khamurzoeva S.Sh., Kulikova N.G. (2013). Puti snizhenija invalidnosti u lic trudosposobnogo vozrasta [Ways to reduce disability in people of working age]. Problemy social'noj gigieny, zdravoohranenija i istorii mediciny [Problems of social hygiene, health care and the history of medicine], 6, 29-31. (In Russ.)
22. Yaroshenko V.P., Miller A.M. (2011). Irritativnye rasstrojstva mocheispuskanija posle transuretral'noj jelektrorezekcii u bol'nyh dobrokachestvennoj giperplaziej predstatel'noj zhelezy. Jeffektivnaja farmakoterapija [Irritative urination disorders after transurethral electroresection in patients with benign prostatic hyperplasia. Effective pharmacotherapy]. Urologija i nefrologija [Urology and Nephrology], 1, 27-28. (In Russ.)
23. Chen S, Zhu L, Cai J, Zheng Z, Ge R, Wu M, 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, 284-291.
24. 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.
25. Kaplan S.A. (2016). Re: EAU Guidelines on the Assessment of Non-Neurogenic Male Lower Urinary Tract Symptoms Including Benign Prostatic Obstruction. J Urol, 196(6), 1712-1714.
26. 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.
27. Nakagava K. (2007). A new minimally invasive medical treatment for prostatic hyperplasia: its current situation and actual practice of the operation; TUEB. Urology View, 5, 95-97.
28. Ou R.B., Deng X.R., Yang W.J., Wei X.H., Chen H., Xie K.J. (2013). Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes > 80mL: a prospective randomized study. BJU Int., 112, 239-245.
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Опубликован
2018-12-25
Как цитировать
Kuznecov, A. V., Larichev, I. V., & Popova, A. Y. (2018). Преимущества биполярной трансуретральной энуклеации при лечении доброкачественной гиперплазии простаты крупных размеров. Вопросы экологии, 8(4), 21–30. https://doi.org/10.25726/NM.2019.22.46.003
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