Сравнительные результаты применения трансуретральной резекции и энуклеации простаты при лечении пациентов с доброкачественной гиперплазией предстательной железы крупных размеров
DOI:
https://doi.org/10.25726/NM.2019.38.86.006Ключевые слова:
доброкачественная гиперплазия предстательной железы, биполярная трансуретральная резекция и энуклеация простаты, гиперплазией предстательной железы крупных размеров, операция, стационар, пациентыАннотация
В представленном исследовании анализируются среднесрочные клинические результаты внедрения биполярной техники выполнения трансуретральной резекции и энуклеации в лечении доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом более 80 см3.
В исследование включено 84 пациента (основная группа), оперированных методом трансуретральной энуклеации предстательной железы, и 112 пациентов – методом биполярной трансуретральной резекции предстательной железы (контрольная группа). При применении исследуемых эндоскопических методов средний срок послеоперационной катетеризации составил 1,3 суток в основной группе и 1,4 дня в группе контроля, интра- и послеоперационные осложнения (кровотечение, инфекционно-воспалительные осложнения) были единичными, причем меньшая частота встречалась в основной группе. Через 6 месяцев после операции скорость потока мочи возросла на 13,9 мл/с в основной группе и на 10,9 мл/с в группе контроля, средний балл по шкале IPSS в итоге составил 3,2±0,2 балла и 4,1±0,1 балла в основной и контрольных группах соответственно (p<0,05).
Полученные результаты в основной группе можно связать с большей радикальностью методики трансуретральной энуклеации простаты (ТУЭБ), объем резидуальной ткани узла в этой группе составил 5,6±0,7 см3 против 14,8±3,2 см3 в группе контроля (p<0,05). Таким образом, метод ТУЭБ может быть рекомендован к освоению врачам-урологам специализированных стационаров, как способ оперативного лечения ДГПЖ крупных размеров.
Библиографические ссылки
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3. Kadyrbekov A.K., Chernetsova G.S. (2017). Klinicheskie osobennosti vedenija bol'nyh posle odnomomentnoj chrespuzyrnoj adenomjektomii [Clinical features of management of patients after simultaneous transvesical adenomectomy]. Vestnik Kyrgyzsko-Rossijskogo slavjanskogo universiteta [Bulletin of the Kyrgyz-Russian Slavic University], 17(7), 30-32. (In Russ.)
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5. 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.)
6. Kulikova N.G. (2000). Lazernaja korrekcija gormonal'nogo disbalansa u muzhchin i zhenshhin zrelogo vozrasta v involjucionnom periode [Laser correction of hormonal imbalance in men and women of mature age in the involutional period]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury [Questions of balneology, physiotherapy and physiotherapy], 8, 59. (In Russ.)
7. Lopatkin H.A. (1999). Oslozhnenija adenomjektomii i TUR predstatel'noj zhelezy [Complications of adenomectomy and TUR of the prostate]. In: Dobrokachestvennaja giperplazija predstatel'noj zhelezy [Benign prostatic hyperplasia] (pp. 210-214). Moscow: "GEOTAR-Media". (In Russ.)
8. Managadze G., Khvadagiani G., Tsereteli A., Abdushelishvili K., Managadze L. (2002). Transurethral resection of the prostate without limiting prostate mass, 10 years of experience. Materials of the X Russian Congress of Urology. Moscow, 142. (In Russ.)
9. Martov A.G., Lopatkin N.A. (1997). Rukovodstvo po transuretral'noj jendoskopicheskoj jelektrohirurgii adenomy prostaty [Guide to transurethral endoscopic electrosurgery of prostate adenoma]. Moscow: Triad H. (In Russ.)
10. Polosyants O.B. (2007). Arterial'naja gipertenzija i dobrokachestvennaja giperplazija predstatel'noj zhelezy (DGPZh) [Arterial hypertension and benign prostatic hyperplasia (BPH)]. Sovremennye podhody k lecheniju. Neotlozhnaja terapija [Modern approaches to treatment]. Emergency treatment, 1(2), 88-93. (In Russ.)
11. Pulatov D.A., Ibragimov Zh.M., Kamyshov S.V. (2017). Sravnitel'naja ocenka toksichnosti lechenija bol'nyh himiorezistentnym kolorektal'nym rakom [Comparative evaluation of the toxicity of treatment of patients with chemoresistant colorectal cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2, 58-61. (In Russ.)
12. Salalykina E.V., Papikyan O.A. (2018). Voprosy optimizacii raboty srednego medicinskogo personala v uslovijah central'noj rajonnoj bol'nicy [Issues of optimizing the work of paramedical personnel in a central district hospital]. International Journal of Medicine and Psychology, 1(2), 12-16. (In Russ.)
13. 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.)
14. 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, 38-42. (In Russ.)
15. Sevryukov F.A. (2012). Transuretral'naja rezekcija v fiziologicheskom rastvore [Transurethral resection in saline]. Urologija [Urology], 2, 67-70. (In Russ.)
16. 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], 1, 109-113. (In Russ.)
17. 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.)
18. 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, 21-23. (In Russ.)
19. 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, 72-74. (In Russ.)
20. 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.)
21. Sergienko N.F., Romanov K.E., Shaplygin L.V., Begaev A.I. (2000). Oshibki, opasnosti i oslozhnenija pri transuretral'noj rezekcii giperplazii predstatel'noj zhelezy [Errors, dangers and complications of transurethral resection of prostatic hyperplasia]. Urologija [Urology], 6, 29-34.
22. Sharafutdinov M.A. (2011). Social'no-gigienicheskie aspekty boleznej mochepolovoj sistemy i mediko-organizacionnye osnovy medicinskoj pomoshhi bol'nym (v uslovijah respubliki Bashkortostan) [Socio-hygienic aspects of diseases of the genitourinary system and the medical and organizational basis of medical care for patients (in the Republic of Bashkortostan)]: Abstract. Moscow, 46.
23. EAU Guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), including benign prostatic obstruction (BPO) / S. Gravas, T. Bach, M. Drake et al. – European Association of Urology, update March 2017. – [Electronic source]. URL: http://uroweb.org/wp-content/uploads/13-Non-Neurogenic-Male-LUTS_2017_web.pdf. (Date of access: 01.07.2019)
24. Gilling P.J., Wilson L.C., King C.J. et al. (2012). Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int., 109(3), 408-411.
25. Ou R., Deng X., Yang W. et al. (2013). Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes > 80 mL: a prospective randomized study. BJU Int., 112, 239-245.
26. Zhang S.Y., Hu H., Zhang X.P., Wang D., Xu K.X., Na Y.Q., Huang X.B., Wang X.F. (2012). Efficacy and safety of bipolar plasma vaporization of the prostate with "button-type" electrode compared with transurethral resection of prostate for benign prostatic hyperplasia. Chin Med J (Engl), 125(21), 3811-3814.
2. Ilchenko G.V., Ischenko O.Yu., Lynova E.N., Prishchep 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.)
3. Kadyrbekov A.K., Chernetsova G.S. (2017). Klinicheskie osobennosti vedenija bol'nyh posle odnomomentnoj chrespuzyrnoj adenomjektomii [Clinical features of management of patients after simultaneous transvesical adenomectomy]. Vestnik Kyrgyzsko-Rossijskogo slavjanskogo universiteta [Bulletin of the Kyrgyz-Russian Slavic University], 17(7), 30-32. (In Russ.)
4. 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), 9. (In Russ.)
5. 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.)
6. Kulikova N.G. (2000). Lazernaja korrekcija gormonal'nogo disbalansa u muzhchin i zhenshhin zrelogo vozrasta v involjucionnom periode [Laser correction of hormonal imbalance in men and women of mature age in the involutional period]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury [Questions of balneology, physiotherapy and physiotherapy], 8, 59. (In Russ.)
7. Lopatkin H.A. (1999). Oslozhnenija adenomjektomii i TUR predstatel'noj zhelezy [Complications of adenomectomy and TUR of the prostate]. In: Dobrokachestvennaja giperplazija predstatel'noj zhelezy [Benign prostatic hyperplasia] (pp. 210-214). Moscow: "GEOTAR-Media". (In Russ.)
8. Managadze G., Khvadagiani G., Tsereteli A., Abdushelishvili K., Managadze L. (2002). Transurethral resection of the prostate without limiting prostate mass, 10 years of experience. Materials of the X Russian Congress of Urology. Moscow, 142. (In Russ.)
9. Martov A.G., Lopatkin N.A. (1997). Rukovodstvo po transuretral'noj jendoskopicheskoj jelektrohirurgii adenomy prostaty [Guide to transurethral endoscopic electrosurgery of prostate adenoma]. Moscow: Triad H. (In Russ.)
10. Polosyants O.B. (2007). Arterial'naja gipertenzija i dobrokachestvennaja giperplazija predstatel'noj zhelezy (DGPZh) [Arterial hypertension and benign prostatic hyperplasia (BPH)]. Sovremennye podhody k lecheniju. Neotlozhnaja terapija [Modern approaches to treatment]. Emergency treatment, 1(2), 88-93. (In Russ.)
11. Pulatov D.A., Ibragimov Zh.M., Kamyshov S.V. (2017). Sravnitel'naja ocenka toksichnosti lechenija bol'nyh himiorezistentnym kolorektal'nym rakom [Comparative evaluation of the toxicity of treatment of patients with chemoresistant colorectal cancer]. Onkologija i radiologija Kazahstana [Oncology and radiology of Kazakhstan], 2, 58-61. (In Russ.)
12. Salalykina E.V., Papikyan O.A. (2018). Voprosy optimizacii raboty srednego medicinskogo personala v uslovijah central'noj rajonnoj bol'nicy [Issues of optimizing the work of paramedical personnel in a central district hospital]. International Journal of Medicine and Psychology, 1(2), 12-16. (In Russ.)
13. 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.)
14. 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, 38-42. (In Russ.)
15. Sevryukov F.A. (2012). Transuretral'naja rezekcija v fiziologicheskom rastvore [Transurethral resection in saline]. Urologija [Urology], 2, 67-70. (In Russ.)
16. 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], 1, 109-113. (In Russ.)
17. 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.)
18. 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, 21-23. (In Russ.)
19. 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, 72-74. (In Russ.)
20. 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.)
21. Sergienko N.F., Romanov K.E., Shaplygin L.V., Begaev A.I. (2000). Oshibki, opasnosti i oslozhnenija pri transuretral'noj rezekcii giperplazii predstatel'noj zhelezy [Errors, dangers and complications of transurethral resection of prostatic hyperplasia]. Urologija [Urology], 6, 29-34.
22. Sharafutdinov M.A. (2011). Social'no-gigienicheskie aspekty boleznej mochepolovoj sistemy i mediko-organizacionnye osnovy medicinskoj pomoshhi bol'nym (v uslovijah respubliki Bashkortostan) [Socio-hygienic aspects of diseases of the genitourinary system and the medical and organizational basis of medical care for patients (in the Republic of Bashkortostan)]: Abstract. Moscow, 46.
23. EAU Guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), including benign prostatic obstruction (BPO) / S. Gravas, T. Bach, M. Drake et al. – European Association of Urology, update March 2017. – [Electronic source]. URL: http://uroweb.org/wp-content/uploads/13-Non-Neurogenic-Male-LUTS_2017_web.pdf. (Date of access: 01.07.2019)
24. Gilling P.J., Wilson L.C., King C.J. et al. (2012). Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int., 109(3), 408-411.
25. Ou R., Deng X., Yang W. et al. (2013). Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes > 80 mL: a prospective randomized study. BJU Int., 112, 239-245.
26. Zhang S.Y., Hu H., Zhang X.P., Wang D., Xu K.X., Na Y.Q., Huang X.B., Wang X.F. (2012). Efficacy and safety of bipolar plasma vaporization of the prostate with "button-type" electrode compared with transurethral resection of prostate for benign prostatic hyperplasia. Chin Med J (Engl), 125(21), 3811-3814.
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Опубликован
2018-12-25
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Torbik, D. V. (2018). Сравнительные результаты применения трансуретральной резекции и энуклеации простаты при лечении пациентов с доброкачественной гиперплазией предстательной железы крупных размеров. Вопросы экологии, 8(4), 50–59. https://doi.org/10.25726/NM.2019.38.86.006
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