新しい幅広型ループを用いた経尿道的前立腺切除術と従来型のループを用いた経尿道的前立腺切除術の比較試験

Abstract

TURPにおける幅広型ループの有用性を検討するため, 従来の細い針金状のループを用いたTURPとの無作為比較試験を行った. 1)手術時間, 術中出血量, 使用灌流液量, 術前・術直後の血清Na値の変化は両群間に有意差は認めなかった. 2)合併症として被膜穿孔, 低Na血症, 後出血, 術後尿道狭窄の発症頻度は両群間に有意差を認めなかった. 3)臨床効果は両群共に著明に改善しており, 両群間に有意差は認めなかった. 4)幅広型ループを用いたTURPは従来のループを用いたTURPに比較して術中出血量の軽減, 切除時間の短縮という点では必ずしも優れてはいなかった

We compared the safety and efficacy of transurethral resection of the prostate (TURP) with a thick loop and with a standard loop. We compared 36 consecutive men (median age, 70 years) with symptomatic benign prostatic hyperlasia (BPH) treated by TURP with a thick loop to a cohort of 36 men (median age, 72 years) treated by TURP with a standard loop. The safety parameters of evaluation included the operative time, blood loss, chronological changes in serum sodium, and complications. The efficacy parameters of evaluation included International Prostate Symptom Score, quality of life assessment, peak urinary flow rate, and post-void residual urine volume. The operative time (median, 49.5 versus 43.5 minutes), blood loss (median, 179 versus 127 ml), and change in serum sodium (median, -4.0 versus -6.0 mEq/L) were not significantly greater in the thick loop group than in the standard loop group, respectively. There were no major complications in either group. Clinically significant improvement was observed in all efficacy parameters in both groups, with no difference between the two groups. These results suggest that TURP with a thick loop is not necessarily superior to TURP with a standard loop in terms of decreasing the blood loss and decreasing the operative time.