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目的研究分析氩氦刀冷冻联合经尿道前列腺电切术治疗中叶明显突入膀胱的前列腺癌的安全性和近期疗效。方法 7例前列腺癌患者,均伴有中叶明显突入膀胱现象,均实施氩氦刀冷冻联合经尿道前列腺电切术治疗,评估手术治疗效果,记录患者并发症情况。结果患者均成功实施手术,手术耗时97~142 min,平均手术耗时(117.6±12.08)min;术中出血量11~23 ml,平均术中出血量(15.24±3.16)ml;冰冻复温时间43~65 min,平均冰冻复温时间(51.36±5.19)min;所有患者在完成手术治疗15 d内未发生导尿管阻塞或血尿现象,仅3例患者伴有尿道絮状物脱出,未治疗自行消散,无尿储留或尿失禁症状;术后复查,患者前列腺体显著性减小,输尿管积水症状得到明显改善或消失。结论氩氦刀冷冻联合经尿道前列腺电切术治疗中叶明显突入膀胱的前列腺癌近期疗效确切,并发症率低,全面解决中叶冷冻消融残留的不足,安全可行。
Objective To study the safety and short-term efficacy of cryoablation combined with transurethral resection of the prostate in the treatment of prostate cancer with obvious mid-bladder invasion. Methods Seven patients with prostate cancer were accompanied with obvious midclavical protrusion into the bladder. All patients were treated with argon-helium cryosurgery combined with transurethral resection of the prostate. The surgical treatment effect was evaluated and the patient’s complications were recorded. Results The patients were successfully operated. The operation time was 97 to 142 minutes and the average operation time was 117.6 ± 12.08 min. The intraoperative blood loss was 11 to 23 ml and the average blood loss was 15.24 ± 3.16 ml. The time was 43-65 min with the average time of freezing-thawing (51.36 ± 5.19) min. No catheter obstruction or hematuria occurred in all the patients within 15 days after operation. Only 3 patients had urethral floccule prolapse, Treatment dissipated, no urine retention or urinary incontinence symptoms; postoperative reexamination, patients with significant reduction of prostate, ureteral hydronephrosis symptoms have been significantly improved or disappeared. Conclusions Argon-helium-knife cryosurgery combined with transurethral resection of the prostate for the treatment of prostate cancer with obvious mid-engneled bladder invasion has definite effect and low complication rate. It is safe and feasible to fully solve the problem of frozen-thawed mid-lobe residual tumor.