国立病院8施設における前立腺手術1,686例の検討 CONSECUTIVE 1, 686 PROSTATECTOMIES AT 8 NATIONAL HOSPITALS
Access this Article
国立8施設の5年間のTUR 1,416例, 開創手術270例, 計1,686例の前立腺手術例を検討した.<br>出血量は手術時間よりも腺腫重量に関係していた. 大きい前立腺の出血量は多く, これは時間当りの出血量に換算しても重量とともに増加していた.<br>恥骨後式の出血量は他の術式にくらべて少なかった.<br>TURは大きい腺腫においても術後のカテーテル抜去, 退院が早いことが確められた.<br>予防的に精管結紮した例で副睾丸炎を起したのは1例のみであった.<br>手術死はなかったが, 術後に心筋梗塞, 消化管出血, 脳梗塞の併発した例がみられた.
Consecutive 1, 686 prostatectomies including 1, 416 transurethral, 111 suprapubic and 159 retropubic prostatectomies done at 8 National Hospitals were studied. Bleeding increased with weight of the resected prostatic tissue in both transurethral and open surgery. The amount of bleeding was closely related with the weight, not with the time of surgical procedure. It was certified by the fact that large prostates were associated with the increasing bleeding/time ratio. The best way to prevent the massive bleeding from large prostates was to choice open retropubic procedure. Transurethral prostatectomy was followed by the shortest catheter drainage and hospital stay, even in cases with large prostate. Prophylactic vasectomy prevented post-operative epididymitis in all but one exceptional case. Although no surgical death was recorded, 5 gastrointestinal bleeding, 2 cardiac infarctions and one cerebral infarction occurred in their post-operative course. Three of them and additional 5 cases died during their hospital stay. Cardiac failure was the main cause of death in the latter cases.
- The Japanese Journal of Urology
The Japanese Journal of Urology 77(10), 1631-1636, 1986
THE JAPANESE UROLOGICAL ASSOCIATION