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  • Title: [Clinical application value of the endoscopic surveillance system in transurethral bipolar plasmakinetic resection of the prostate].
    Author: Wang LJ, Wang ZP, Bao JS, Mi J.
    Journal: Zhonghua Nan Ke Xue; 2020 May; 26(5):414-421. PubMed ID: 33354949.
    Abstract:
    OBJECTIVE: To evaluate the clinical application of the endoscopic surveillance system (ESS) in transurethral bipolar plasmakinetic resection of the prostate (TUPKRP). METHODS: We retrospectively analyzed 136 cases of TUPKRP performed with the assistance of ESS from September 2018 to March 2019. According to the prostate volume (PV), we divided the patients into a PV ≥ 60 ml and a PV < 60 ml group, and compared the surgery-related parameters between the two groups of patients. RESULTS: Operations were successfully completed in all the 136 cases. Statistically significant differences were observed between the PV ≥ 60 ml and a PV < 60 ml groups in the operation time (［78.93 ± 28.63］ vs ［51.77 ± 14.85］ min, P < 0.05), intraoperative blood loss (［261.61 ± 204.25］ vs ［69.26 ± 61.13］ ml, P < 0.05) and absorption of the rinse fluid (［948.20 ± 656.00］ vs ［347.39 ± 256.53］ ml, P < 0.05), but not in the postoperative red cell count, levels of hemoglobin, hematocrit and ions, hospital stay, incidence of prostatic perforation or blood transfusion (P > 0.05). The patients also showed statistically significant differences between the baseline and postoperative parameters in red cell count (［4.62 ± 0.63］ vs ［4.31 ± 0.74］ ×1012/L, P < 0.05) and levels of hemoglobin (［141.83 ± 18.30］ vs ［135.20 ± 19.91］ g/L, P < 0.05), K+ (［4.01 ± 0.43］ vs ［3.92 ± 0.54］ mmol/L, P < 0.05) and Na+ (［141.90 ± 3.11］ vs ［139.42 ± 3.81］ mmol/L, P < 0.05), but not in the levels of Cl－ (［103.74 ± 9.32］ vs ［103.70 ± 4.50］ mmol/L, P > 0.05) and Ca2+ (［2.21 ± 0.13］ vs ［2.19 ± 0.21］ mmol/L, P > 0.05). CONCLUSIONS: Large-volume absorption of rinse fluid may overburden the circulatory system and induce left ventricular failure, pulmonary edema or massive bleeding during PKRP for patients with PV ≥ 60 ml due to long operation time and rich blood supply in the hyperplasia gland. The endoscopic surveillance system can provide real-time data on the absorption of rinse fluid and bleeding, reduce complications, and improve surgical safety.
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