経尿道的切除術TURにおける血液化学的研究並びにBalance study

Abstract

1) Blood chemistry and balance study of water and sodi u m chloride were performed before and after TUR prostate, bladder neck and bladder tumor, and interesting results were obtained. 2) Blood chemistry (51 cases) : Significant changes were not found in cases of TUR bladder neck and bladder tumor. On the contrary, in TUR prostate were noted transient post-operative decrease of sodium and chloride and transient increase of potassium, nonprotein nitrogen and glucose. Coy combining power changed in somewhat opposite direction to the change of chloride. Protein and hematocrit also showed some decrease temporarily. 3) Balance study of water and sodium chloride (42 cases): Marked changes were not found in cases of TUR bladder neck and bladder tumor. On the contrary, in cases of TUR prostate, as in retropubic prostatectomy, post-operative balance of both water and sodium chloride was followed by negative balance, and then normal balance was regained toward the third post-operative day. Degree of positive balance in TUR prostate as well as intake and output was greater than in open prostatectomy, indicating more important effect on the circulatory system and the kidney. 4) Absorption of irrigating fluid, ine v itable specific factor in TUR prostate, together with the stress in common in any surgery are considered to cause those changes during and after resection. 5) The results described above lead to the following conclusions. 1. TUR bladder neck and bladder tumor gives little i n fluence on the general condition of patients and can be considered a minor surgery. 2. TUR prostate, on the contrary, shou l d be considered a major surgery comparable with the open prostatectomy and may give a greater influence on the circulatory system and the kidney. Selection of cases for TUR prostate must be done with more caution than for open prostatectomy.