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首页> 外文期刊>BJU international >How to master absorption during transurethral resection of the prostate: basic measures guided by the ethanol method.
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How to master absorption during transurethral resection of the prostate: basic measures guided by the ethanol method.

机译：如何在经尿道前列腺切除术中掌握吸收：乙醇法指导的基本措施。

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Objective To evaluate the effect of basic measures to minimize the absorption of irrigating fluid during transurethral resection of the prostate (TURP) to the planned end-point, using the ethanol method to guide the surgeon. Patients and methods Forty-six patients underwent TURP with intermittent irrigation using sterile water and 2% ethanol. The ethanol content in the expired breath of the patients was assessed every 5 min using a breath-alcohol monitor. In 25 patients no absorption was indicated but 21 showed some absorption according to the ethanol analyses. The operator was then immediately alerted, paused briefly to determine the route of absorption and to take advantage of blood clots to seal off leakage sites. On resuming the resection, attention was given to the pressure gradients in the operating field, based on bladder compliance and the flow in the irrigating jet. Repeated ethanol analyses were used to assess the result and to guide the surgeon's efforts. Results No operation had to be terminated prematurely; the mean absorption in the 21 patients in whom any ethanol was detected was 121 (75-230) mL. In 14 patients absorption occurred once, in six twice and in one there were three small absorption events. The group with absorption did not differ significantly from that with no absorption in operative duration (mean 48 and 47 min), resected weight (mean 32.8 and 31.6 g) or blood loss (mean 550 and 483 mL). Conclusions If the surgeon is alerted at the first positive ethanol reading, effective measures to minimize absorption can be taken early. Regular use of the ethanol method as an alarm system should permit TURP with a minimum of absorption and avoid an early interruption or premature termination of surgery because of absorption.
机译：目的采用乙醇方法指导外科医生，评估在经尿道前列腺电切术（TURP）至计划的终点期间使冲洗液吸收最小化的基本措施的效果。患者和方法对46例患者进行了TURP间歇性冲洗，使用无菌水和2％的乙醇。使用呼气酒精监测仪每5分钟评估一次患者呼出气中的乙醇含量。根据乙醇分析，在25名患者中未显示出吸收，但21名患者显示出一定吸收。然后立即提醒操作员，短暂停顿一下以确定吸收的途径，并利用血块封闭泄漏部位。在恢复切除时，根据膀胱顺应性和冲洗射流中的流量，对手术区域的压力梯度给予了关注。重复的乙醇分析用于评估结果并指导外科医生的努力。结果无需提前终止任何操作;在21名检测到乙醇的患者中，平均吸收为121（75-230）mL。在14位患者中，吸收发生了一次，六次发生了两次，在一个患者中发生了三个小吸收事件。有吸收的组与没有吸收的组在手术时间（分别为48和47分钟），切除的体重（分别为32.8和31.6 g）或失血（分别为550和483 mL）方面没有显着差异。结论如果在乙醇首次读数为正值时向医生发出警报，则可以及早采取有效措施以最大程度地减少吸收。定期使用乙醇方法作为警报系统应允许TURP吸收最少，并避免由于吸收而提前中断手术或过早终止手术。

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