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首页> 外文会议>Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII >Endoscopic laser incision of the prostate
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Endoscopic laser incision of the prostate

机译：前列腺内窥镜激光切口

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Abstract: To reduce morbidity and costs of transurethral incision of the prostate in cases with bladder neck obstruction and insignificant prostatic hyperplasia, a Nd:YAG laser, wavelength 1064 nm, was used for endoscopic tissue vaporization. Twenty seven patients suffering from severe urinary obstructive symptoms due to a high-riding vesical neck, were operated on under general anesthesia. Under endoscopic control and by means of a 600 micrometer lateral- firing quartz fiber two incisions were performed, starring at the 7 o'clock and 5 o'clock position, respectively, of the bladder neck and following the floor of the prostatic urethra to either side of the verumontanum. Vaporization was achieved with the fiber in permanent tissue contact and the laser working at 60 W power in continuous mode. Total energy averaged 10,000 J. No catheter was inserted and all patients were discharged on the same day after the first micturition. Anti-inflammatory agents were administered for two weeks. No serious complications were encountered postoperatively. Results were evaluated by means of clinical examination, uroflowmetry, sonographic measurement of residual urine and the International Prostate Symptom Score (IPSS) questionnaire. Considering a mean follow up of 15 months, all patients experienced considerable improvement of their obstruction, their urinary peak flow averaging 21 ml/s and their IPSS score 6.7 (preoperatively 12.2 ml/s and 21.8, respectively). As compared to the Collings knife, laser-incision of the prostate carries no risk of bleeding, thus obviating the need of catheterization. It can safely be done in an outpatient setting, probably as well under local as under general anesthesia. !6
机译：摘要：为减少膀胱颈阻塞和前列腺增生不明显的情况下经尿道前列腺切开术的发病率和费用，使用Nd：YAG激光（波长为1064 nm）进行内镜组织汽化。在全麻下对27例因高位膀胱颈而患有严重尿路阻塞症状的患者进行了手术。在内窥镜控制下，通过600微米的侧面发射石英纤维，进行了两个切口，分别在膀胱颈的7点钟和5点钟位置开始，并沿着前列腺尿道的底部verumontanum的一侧。在永久组织接触的情况下，光纤以连续模式在60 W功率下工作，从而实现了汽化。平均总能量为10,000J。在第一次排尿后的同一天，未插入导管，所有患者均已出院。给予抗炎药两周。术后未见严重并发症。通过临床检查，尿流测定法，超声检查残留尿液和国际前列腺症状评分（IPSS）问卷对结果进行评估。考虑平均15个月的随访，所有患者的梗阻均有明显改善，平均尿峰值流量为21 ml / s，IPSS评分为6.7（术前分别为12.2 ml / s和21.8）。与科林斯刀相比，激光切开前列腺没有出血的风险，因此不需要导管插入。可以在门诊环境中安全地完成，可能在局部麻醉或全麻情况下也是如此。 ！6

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