Outcome of Transurethral Wedge Loop Vaporization-Resection versus Conventional Transurethral Resection Treatment for Benign Prostatic Hyperplasia

以Wedge Loop進行經尿道汽化切除手術與傳統經尿道切除手術治療攝護腺肥大症之比較

劉志光(Chih-Kuang Liu) ； 柯明中(Ming-Chung Ko) ； 李文凱(Wen-Kai Lee) ； 鄭惠升(Huey-Sheng Jeng) ； 江漢聲(Han-Sun Chiang)

《北市醫學雜誌》 3卷2期 (2006/02) Pp. 147-158

https://doi.org/10.6200/TCMJ.2006.3.2.05

摘要

目的：使用Wedge Loop與傳統電刀切除環進行經尿道治療攝護腺肥大症之五年成效追蹤。方法：自1997年1月至1999年11月止，共有攝護腺肥大症病患146名依序分成兩組，進行使用Wedge Loop或傳統電刀切除環經尿道切除手術。所有病患術前皆有詳細病史、體檢、主觀症狀量表、生活品質量表、攝護腺特異抗原、最大尿流率、攝護腺體積與餘尿量等。術中各項指標以及術後追蹤成效、不良作用與再治療率等至五年止。結果：二組在手術時間無差異(p=0.1)，然而手術中之出血量、沖洗液量、導尿管留置與住院時間有明顯意義。二組術後主觀症狀量表、生活品質量表、最大尿流率與餘尿量等較術前有顯著進步，但在二組間無差異。不良作用如性功能障礙、尿道狹窄與尿失禁等無統計學意義；二組間之再治療率於術後二年(p=0.51)與術後五年(p=0.59)無差異。結論：以Wedge Loop進行經尿道攝護腺切除手術相較於傳統切除環手術，在長期成效追蹤上，顯現出相似的結果；但更具有術中與術後多項指標之優點，或可成為攝護腺肥大症手術治療之另一選擇。

關鍵字

攝護腺肥大症 ； Wedge Loop ； 經尿道攝護腺切除術

並列摘要

Background and Purpose: To study the 5-year outcome of transurethral Wedge Loop raporization-resection versus conventional transurethral resection treatment for patients with prostatic hyperplasia (BPH). Methods: This prospective randomized study was performed between January 1997 and November 1999. Seventy-two patients with symptomatic BPH undergoing transurethral vaporization-resection (TUVRP) using ”Wedge Loop” compared to that of seventy-four cases with conventional transurethral resection of the prostate (TURP). All cases were assessed international prostate symptom score (I-PSS), quality of life (QOL) score, peak urinary flow rate (Qmax), prostatic volume, and post-void residual volume (PVR). Perioperative details and postoperative complications were recorded. Baseline, 3 months, 1, 2, 3 and 5 years follow-up data were analyzed. Results: The operation time was no difference (p=0.1) whereas perioperative hemorrhage, fluid irrigation amount, catheterization and length of hospital stay were significant between these two groups. Improvement in I-PSS, Qmax, prostate volume, and PVR were also significant in each group at 3-month review. Adverse events included that the sexual impotence, retrograde ejaculation, urethral stricture and urinary incontinence were no difference between two groups at 2-year end. The retreatment rates were 8% versus 9.8% (p=0.51) at 2 years and 9.7% versus 11.1% (p=0.59) at 5 years. 20 (27.8%) cases of TUVRP and 21 (28.4%) cases of TURP completed 5 years follow-up, and revealed no difference in treatment durability (p＞0.05). Conclusion: Transurethral Wedge Loop electrovapour resection appears to have perioperative advantages over TURP and the long-term outcome durability seems equivalent each other.

並列關鍵字

benign prostatic hyperplasia BPH ； vaporization-resection ； Wedge Loop ； transurethral prostatectomy TURP