新型多波光鐳射攝護腺手術：新光醫院經驗
朱懿柏1、吳子翔1 、林宜佳1,2、蔡德甫1,2、陳宏恩1、鄭以弘1、莊光達1,2、黃一勝1,2
1財團法人新光吳火獅紀念醫院 外科部 泌尿外科
2天主教輔仁大學醫學院 泌尿外科
New MultiPulseâ Laser Prostatectomy for Benign Prostate Hyperplasia:
Priliminary Experience in Shin Kong Memorial Hospital
Yi-Bo Chu1、Tzu-Hsiang Wu 1、Yi-Chia Lin 1,2、Te-Fu Tsai 1,2、Hung-En Chen1、Yi-Hung Cheng1、Guang-Dar Juang 1,2、Thomas I.S. Hwang 1,2
1 Division of Urology, Department of Surgery, Shin-Kong WHS Memorial Hospital, Taipei, Taiwan
2Department of Urology, Fu Jen Catholic University School of Medicine, Taipei, Taiwan
Purpose:
Transurethral resection of the prostate (TURP) is the gold standard procedure for the surgical treatment of benign prostate hyperplasia with bladder outflow obstruction, and the invention of laser modality used in TUR-P improves the outcomes and reduce the morbidity. MultiPulseâ Tm+1470 laser is a new laser modality which combines Thulium:YAG 120W and Module 30W (1940nm +1470nm). We herein report the outcomes of MultiPulseâ laser TUR-P for BPH in our institution.
Materials and Methods:
From 2015 October to 2016 March, 36 patients with BPH has received MultiPulseâ laser TUR-P. Demographics, size of prostate, PSA, operation time and post-op complicationswere collected with a retrospective medical record review. Moreover, the previous data of patients who underwent conventional TURP and Thulium or Diode laser prostatectomy in our hospital are compared.
Results:
Among the 36 patients, the mean age was 70.2 ± 8.62 years old. The mean size of prostate was 70.0 ± 34.9 gm, and size of the transition zone was 35.04 ± 22.24gm. The mean PSA level was 12.69 ± 26.9, and two cases of prostate adenocarcinoma were found. The mean operative time was 111.83 ± 59.21 minutes, and 25.11 ± 22.45 gm of specimen was collected. The mean days of hospital stay was 5.69 ± 3.02 days, and 5.29 ± 2.59 days after excluding the two cancer patients, because of further staging workup arrangement. No post-op blood transfusion was given. No post-op urine retention was noted. The resected weight of prostate is larger than previous 2 groups, however, length of hospital stay is not significant among the 3 groups.
Conclusion:
The new laser modality, MultiPulseâ Tm+1470 laser, is available for TUR-P, and the result is comparable with previous laser prostatectomy. Further study with larger patients group and long-term follow-up is mandutory.