THE ROLE OF EXTRAPERITONEOSCOPIC ADENOMECTOMY IN THE MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA GREATER THAN 80 CM3


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Introduction. The current standard of surgery for benign prostatic hyperplasia (BPH) greater than 80 cm3 includes open adenomectomy and holmium enucleation. Transurethral resection and laser vaporization are second line interventions, while the role of laparoscopic extraperitoneal adenomectomy is not fully understood. Aim. To evaluate the role of laparoscopic technique as a surgical modality for BPH greater than 80 cm3. Materials and methods. This study retrospectively evaluated the results of 79 patients (mean age 68 years) who underwent transcapsular extraperitoneoscopic adenomectomy from 2011 to 2016. Results. The mean operative time was 206 (100-450) min; the prostate volume was 134 (80-300) cm3, blood loss was 256 (30-1200) ml. The I-PSS score after surgery decreased by an average of 18.3 points, the maximum urinary flow rate increased by 12 ml/s, the residual urine volume reduced from 147 to 28 ml. 35 (44%) patients underwent simultaneous operations (inguinal hernioplasty, cystolithotomy, etc.). There was one intraoperative complication, and 10 (12.6%) patients had postoperative complications. There were no conversions to open surgery. Incidental prostate cancer was detected in one patient. None of the patients required repeat surgery for infravesical obstruction. Conclusion. Extraperitoneoscopic adenomectomy is efficient, safe and reproducible surgical modality able to take the place of open surgery. There is a need for an evidence base to support the optimal choice between various minimally invasive techniques. Currently, laparoscopic procedure is more justified in patients with concomitant diseases, which can be simultaneously corrected.

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作者简介

R. Biktimirov

Federal Clinical Center for High Medical Technologies FMBA of Russia; A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia

Email: rafbik@kbll9.ru
Ph.D., Head of the Department of Urology Moscow Region, Khimki, Russia

A. Martov

A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia

Email: martovalex@mail.ru
Dr.Med.Sci., Prof. at the Department of Urology and Andrology

T. Biktimirov

Federal Clinical Center for High Medical Technologies FMBA of Russia; A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia

Email: Gabastm@mail.ru
Urologist at the Department of Urology Moscow Region, Khimki, Russia

A. Kaputovskii

Federal Clinical Center for High Medical Technologies FMBA of Russia

Email: kaputovsky79@mail.ru
Urologist Moscow Region, Khimki, Russia

参考

  1. WHO. Ageing and health. http://www.who.int/mediacentre/ factsheets/fs404/en/
  2. Reich O., Gratzke C., Bachmann A., Seitz M., Schlenker B., Hermanek P., Lack N., Stief C.G. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10654 patients. J Urol. 2008;180(1):246-249.
  3. Mariano M.B., Tefilli M.V., Graziottin T.M., Morales C.M., Goldraich I.H. Laparoscopic prostatectomy for benign prostatic hyperplasia-a six-year experience. Eur Urol. 2006;49(1):127-131.
  4. Castillo O., Vidal-Mora I., Rodriguez-Carlin A., Silva A., Schatloff O. Modified urethrovesical anastomosis during robot-assisted simple prostatectomy: Technique and results. Prostate Int. 2016;4(2):61 - 64. doi: 10.1016/j.prnil.2016.04.001.
  5. Oktay B., Koc G., Vuruskan H., Danisoglu M.E., Kordan Y. Laparoscopic extraperitoneal simple prostatectomy for benign prostate hyperplasia: a two-year experience. Urol J. 2011;8(2):107- 112.
  6. Yun H.K., Kwon J.B., Cho S.R., Kim J.S. Eearly experience with laparoscopic retropubic simple prostatectomy in patients with voluminous bening prostatic hyperplasia ( BPH). Korean J Urol. 2010;51(5):323-9. doi: 10.4111/kju.2010.51.5.323.
  7. Xie J.B., Tan Y.A., Wang F.L., Xuan Q., Sun Y.W., Xiao J., Zhu Y.P., Zhou L.Y. Extraperitoneal laparoscopic adenomectomy (Madigan) versus bipolar transurethral resection of the prostate for benign prostatic hyperplasia greater than 80 ml: complications and functional outcomes after 3-year follow-up. J Endourol. 2014;28(3):353-359. doi: 10.1089/end.2013.0374.
  8. Seroukhov A.Yu., Pronkin E.A., Glinin K.I., Mamaev I.E. Laparoscopic Adenomectomy (Preliminary Results). Urology Herald. 2016;1:24-32.
  9. Gravas (Chair) S., Bach T., Bachmann A., Drake M., Gacci M., Gratzke C., Madersbacher S., Mamoulakis C., Tikkinen K.A.O. Guidelines on the Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). European Association of Urology 2015.
  10. Mitropoulos (Chair) D., Artibani W., Graefen M., Remzi M., Rouprêt M., Truss M.C. Guidelines on Reporting and Grading of Complications after Urologic Surgical Procedures. European Association of Urology. 2015.
  11. Lucca I., Shariat S.F., Hofbauer S.L., Klatte T. Outcomes of minimally invasive simple prostatectomy for benign prostatic hyperplasia: a systematic review and meta-analysis. World J Urol. 2015;33(4):563-70. doi: 10.1007/s00345-014-1324-3.
  12. Umari P., Fossati N., Gandaglia G., Pokorny M., De Groote R., Geurts N., Goossens M., Schatterman P., De Naeyer G., Mottrie A. Robotic Assisted Simple Prostatectomy (RASP) versus Holmium Laser Enucleation of the Prostate (HoLEP) for lower urinary tract symptoms in patients with large volume prostates (>100 ml): a comparative analysis from a high-volume center. J Urol. 2017;197(4):1108-14. doi: 10.1016/j.juro.2016.08.114.
  13. Xing N., Guo Y., Yang F., Tian L., Zhang J., Yan Y., Kang N., Xin Z., Niu Y. Laparoscopic simple prostatectomy with prostatic urethra preservation for benign prostatic hyperplasia. Transl Androl Urol. 2012;1(1):9-13. doi: 10.3978/j.issn.2223-4683.2012.02.03.

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