Name: surgical treatment for benign prostatic hyperplasia: holmium laser enucleation of the prostate (holep).
Uploaded: 2018-03-06T12:30:00
Description: Watch this Scientific Journal Video about Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP. at JoVE.com

作者没有什么可透露的。

本研究获得了上海九人民医院伦理委员会的伦理认同和每位患者的书面知情同意。
1. 病人和外科材料
备注:根据欧洲泌尿外科协会的指导原则, 确诊为 BPH 并需要手术治疗的患者可包括10。这种手术过程需要经验和长时间的学习曲线。外科医生的经验是完成这项技术的最重要的因素之一, 特别是前列腺的体积超过100克。钬激光微...

<ol>
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M., Lehrich, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transurethral+holmium+laser+enucleation+versus+transvesical+open+enucleation+for+prostate+adenoma+greater+than+100+gm.::+a+randomized+prospective+trial+of+120+patients.">Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm.:: a randomized prospective trial of 120 patients.</a> J Urol. 168 (4 Pt 1), 1465-1469 (2002).</li><li>Elzayat, E., Habib, E., Elhilali, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Holmium+laser+enucleation+of+the+prostate+in+patients+on+anticoagulant+therapy+or+with+bleeding+disorders.">Holmium laser enucleation of the prostate in patients on anticoagulant therapy or with bleeding disorders.</a> J Urol. 175 (4), 1428-1432 (2006).</li><li>Oelke, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=EAU+guidelines+on+the+treatment+and+follow-up+of+non-neurogenic+male+lower+urinary+tract+symptoms+including+benign+prostatic+obstruction.">EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction.</a> Eur Urol. 64 (1), 118-140 (2013).</li><li>Xu, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+and+safety+of+an+improved+technique+of+holmium+laser+enucleation+of+the+prostate+versus+open+prostatectomy+in+treating+enlarged+prostates+combined+with+multiple+bladder+stones:+one-year+of+followup.">Efficacy and safety of an improved technique of holmium laser enucleation of the prostate versus open prostatectomy in treating enlarged prostates combined with multiple bladder stones: one-year of followup.</a> Int J Clin Exp Med. 9 (12), 23612-23617 (2016).</li><li>Chen, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+improved+morcellation+procedure+for+holmium+laser+enucleation+of+the+prostate.">An improved morcellation procedure for holmium laser enucleation of the prostate.</a> J Endourol. 26 (12), 1625-1628 (2012).</li><li>El Tayeb, M. 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在本议定书中, 我们介绍了前列腺增生症的外科治疗方法。计画可以在日常的临床实践中使用。如前所述, 前列腺增生手术的发展包括三个地标。第一个是开放性手术。根治前列腺切除术和耻骨上开放性前列腺切除术在临床上有广泛的应用。尽管如此, 这种技术还是有严重的不良副作用, 在围手术期经常会出现。这些副作用包括出血, 手术后的大疤痕, 缓慢的病人恢复。此外, 手术领域仅限于骨盆腔?...

良性前列腺增生 (BPH) 是前列腺增生, 发生在老年男性。这种情况开始在大约 40 y 老, 并且发病率可能到达 50%-60% 为男性在他们的60s 和 80%-90% 为男性在他们的70s 和 80s1。BPH 导致渐进性梗阻, 下尿路症状, 保留及其并发症, 甚至肾衰竭, 所有这些都降低了老年男性的生活质量。经医学治疗后, 外科治疗常被用作症状性前列腺增生症的最有效治疗方法。
为治疗前列腺增生症的症状, 包括在 1894年2和经尿道内窥镜手术 (前列腺切除术) 的第一次开放性前列腺摘除术, 已开发了各种类型的手术。经尿道前列腺切除术自其发展以来, 已被认为是手术纾缓扩张的金标准。
钬激光的波长为 2120 nm, 类似于组织水的3, 它会诱发水的汽化。组织穿透率达0.4 毫米, 凝血也可与之一起操作。该过程最初是在 1994年4中为 BPH 引入的。在 1998年, 彼得针梳机使用该设备执行摘除应用程序5。正如彼得针梳机等人在二十世纪九十年代4中提出的那样, 钬激光摘除前列腺 (计画) 是用来治疗前列腺增生症的两个早期类型的手术, 包括开放摘除和经尿道前列腺切除术4。随着增生过程的发展, 前列腺周围区由过渡区围困, 形成所谓的手术胶囊。计画允许切除前列腺的增生部分, 分离前列腺胶囊。因此, 计画, 作为解剖手术, 可以 enucleate 扩大的前列腺区从形成分离之间的间隔和胶囊。与传统的手术方法相比, 计画可能更安全、更有效、更彻底, 并具有持久的效果。与经尿道前列腺切除术相比, 钬降低了手术时间、灌水时间、导尿管的时机, 缩短了住院天数。6,7,8该技术还可以安全地执行抗凝治疗或出血紊乱的患者9。虽然计画有不同的程序, 但主要的程序与下面提到的是相同的。我们还介绍了我们自己的经验和这种方法的创新, 以使它更容易接受和缩短学习曲线。该程序特别适用于大前列腺和那些结合膀胱结石, 鉴于钬激光也可以用于碎石术8。本文介绍了该技术及具体程序。

<table border="0" cellpadding="0" cellspacing="0" width="1069">
	<tbody>
		<tr height="40">
			<td height="40" style="height:40px;width:260px;">holmium laser</td>
			<td style="width:205px;">Lumenis, USA</td>
			<td style="width:344px;"></td>
			<td style="width:260px;">PowerSuite 100W</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">mechanical morcellator</td>
			<td>Lumenis, USA</td>
			<td></td>
			<td>VersaCut</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">27Fr continuous flow resectoscope</td>
			<td>Storz, Tuttlingen, Germany</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

surgical treatment for benign prostatic hyperplasia: holmium laser enucleation of the prostate (holep).

良性前列腺增生 (BPH) 通常发生在老年男性。病情导致下尿路症状, 从而降低生活质量。前列腺增生症包括2主要治疗: 药物和手术。外科治疗通常是最有效和最后的干预。钬激光摘除前列腺 (计画), 其中一个最有效的手术程序, BPH, 是进行 transurethrally。在外科手术中, 最重要和最困难的部分是定位前列腺手术胶囊, 这与解剖手术的理念是一致的。治疗前列腺不同部位可能需要不同的技能。计画具有良好的止血性能, 能够治疗膀胱结石, 这可能是前列腺增生症的并发症。该技术特别适用于不同体积和大小的前列腺。事实上, 计画也提出了一些缺点, 如长时间学习曲线和昂贵的设备。无论如何, 这种方法可能是 "新标准" 和优秀的手术治疗前列腺增生症的方法。

回顾性数据, 收集从2015年到 2016, 是从我的临床数据库的部门。本研究共招收100例前列腺增生症患者。围手术期结果包括: 术后时间 (OT)、术后血红蛋白减少、Na+变异、住院持续时间、膀胱冲洗时间和随访数据。在我们的研究中也收集了基本的病人特征。此外, 还注意到插管时间和住院时间。术后1、4、24周采集随访资料和术后尿并发症。所有数据都显示在表 1</...

Watch this Scientific Journal Video about Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP. at JoVE.com

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.

在这里, 我们提出一个安全和有效的协议, 钬激光摘除前列腺, 治疗良性前列腺增生。

良性前列腺增生的外科治疗: 钬激光前列腺摘除术 (计画)。

Benign prostatic hyperplasia (BPH) commonly occurs among elderly males. The condition causes symptoms in the lower urinary tract, thereby reducing the ...

Research

JoVE Journal

Medicine

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).

Improved Protocol For Laser Microdissection Of Human Pancreatic Islets From Surgical Specimens

从手术标本的人类胰岛细胞激光显微切割的改进方法

Laser microdissection (LMD) is a technique that allows the recovery of selected cells and tissues from minute amounts of parenchyma 1,2. The dissected ...

科研

医学

Renal Capsule Xenografting and Subcutaneous Pellet Implantation for the Evaluation of Prostate Carcinogenesis and Benign Prostatic Hyperplasia

肾小囊和异种移植皮下颗粒植入前列腺癌发生和良性前列腺增生症的评价

New therapies for two common prostate diseases,  prostate cancer (PrCa) and benign prostatic hyperplasia (BPH), depend  critically on experiments ...

Laser-capture Microdissection of Human Prostatic Epithelium for RNA Analysis

人类前列腺上皮的激光捕获显微切割的RNA分析

The prostate gland contains a heterogeneous milieu of stromal, epithelial, neuroendocrine and immune cell types.  Healthy prostate is comprised of ...

Murine Prostate Micro-dissection and Surgical Castration

鼠前列腺微解剖和手术去势

Mouse models are used extensively to study prostate cancer and other diseases. The mouse is an excellent model with which to study the prostate and has ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

在耐药性颞叶癫痫患者卵圆孔电极记录的网络分析

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Transcanalicular 二极管激光辅助泪囊鼻腔吻合术治疗原发性鼻泪管阻塞

Today&#39;s gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), ...

Balloon-based Injury to Induce Myointimal Hyperplasia in the Mouse Abdominal Aorta

球囊损伤诱发小鼠腹主动脉 Myointimal 增生的研究

The use of animal models is essential for a better understanding of MH, one major cause for arterial stenosis.In this article, we demonstrate a murine ...

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser

选择性绿激光锂三硼酸晶体激光 Vaporesection 前列腺的研究

The occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem with a high incidence in the aging ...

Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis

人类布鲁塞拉性皮诺皮诺皮炎的诊断和手术治疗

Brucellar spondylodiscitis (BS) is the most prevalent and significant osteoarticular presentation of human Brucellosis, which is commonly manifested in ...

Focal Laser Ablation of Prostate Cancer: An Office Procedure

前列腺癌聚焦激光消融：办公室程序

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually ...