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

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Etisk godkendelse blev opnået fra den etiske udvalg af Shanghai niende People's Hospital og skriftlig informeret samtykke fra hver enkelt patient blev opnået i vores undersøgelse.
1. patienter og kirurgisk materialer
Noter: Patienter diagnosticeret med BPH og har brug for kirurgisk behandling i overensstemmelse med de europæiske urologiforening (EAU) retningslinjer kan være inkluderet10. Denne kirurgiske procedure kræver ...

<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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J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HoLEP+has+come+of+age.">HoLEP has come of age.</a> World J Urol. 33 (4), 487-493 (2015).</li><li>Qian, X., 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=Functional+outcomes+and+complications+following+B-TURP+versus+HoLEP+for+the+treatment+of+benign+prostatic+hyperplasia:+a+review+of+the+literature+and+Meta-analysis.">Functional outcomes and complications following B-TURP versus HoLEP for the treatment of benign prostatic hyperplasia: a review of the literature and Meta-analysis.</a> Aging Male. 20 (3), 184-191 (2017).</li><li>Xu, H., Chen, Y. 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I denne protokol indfører vi en procedure for kirurgisk behandling af BPH. HoLEP kan være ansat i daglig klinisk praksis. Som nævnt, omfatter udvikling af BPH kirurgi tre vartegn. Først er den åben kirurgi. Retropubic prostatektomi og suprapubic åbne prostatektomi har udstrakt grad været ansat i de kliniske omgivelser i lang tid. På trods af dette indebærer teknikken alvorlige bivirkninger, som er ofte observeret i perioperative perioden. Disse bivirkninger omfatter blødning, store ar efter operation og langsom...

Benign prostatahyperplasi (BPH), som er hyperplasi af prostata, opstår hos ældre mænd. Denne betingelse starter ved ca. 40 y gamle og sygelighed kan nå 50-60% for mænd i deres 60 ' erne og 80-90% for mænd i deres 70 'er og 80 'er1. BPH forårsager progressive obstruktion, lavere urinvejsinfektion symptomer, fastholdelse og dens komplikationer, og endda nyresvigt, som alle sænke livskvaliteten for den ældre mand. Efter medicinsk behandling bruges kirurgisk behandling ofte som den mest effektive behandling af symptomatisk BPH.
Forskellige typer af kirurgi er blevet udviklet for at behandle symptomerne på BPH, herunder den første åbne prostatektomi indført i 18942 og transuretral endoskopisk kirurgi (TURP) et århundrede senere. Siden sin udvikling, er TURP blevet betragtet som guldstandarden til kirurgisk afhjælpe blærehalskirtel.
Holmium laser opererer ved en bølgelængde på 2120 nm, som ligner den væv vand3, som inducerer fordampning af vand. Væv penetration når 0,4 mm, og koagulation kan også betjenes med det. Processen blev introduceret for BPH i 19944. I 1998 brugt Peter Gilling enheden til at udføre enucleation program5. Som foreslået af Peter Gilling et al. i 1990s4anvendes holmium laser enucleation af prostata (HoLEP) til behandling af BPH ved at kombinere de to tidligere typer af kirurgi, herunder den åbne enucleation og TURP4. Med udviklingen af hyperplasi proces trindt i prostata yderzone af overgangszone (TZ) til at danne en såkaldt kirurgisk kapsel. HoLEP giver mulighed for fjernelse af den hyperplasic del af prostata, TZ, der adskiller prostata kapslen. Således kan HoLEP, som den anatomiske kirurgi, enucleate den udvidede prostata zone fra den dannede adskillelse mellem TZ og kapsel. Sammenlignet med den traditionelle kirurgiske metode, kan HoLEP være sikrere, mere effektiv og grundig med holdbare resultater. Sammenlignet med TURP, reduceret holmium varigheden, kunstvanding tid og kateter tid af proceduren og kortere hospitalsophold. 6 , 7 , 8 teknikken kan også udføres sikkert på patienter, der er i antikoagulationsbehandling eller med blødning lidelser9. Selv om der er forskellige former for procedurer for HoLEP, er den vigtigste fremgangsmåden den samme som nævnt i det følgende. Vi introducerer også vores egne erfaringer og innovation for denne metode for at gøre det lettere at acceptere og forkorte indlæringskurven. Proceduren er specielt velegnet til store prostata og dem kombineret med blæresten, eftersom holmium laser kan også bruges til lithotripsi8. Denne artikel introducerer denne teknik og den detaljerede procedure.

<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).

Benign prostatahyperplasi (BPH) forekommer almindeligt blandt ældre mænd. Betingelsen årsager symptomer i de nedre urinveje, hvorved livskvaliteten. BPH indeholder 2 store behandlinger: medicin og kirurgi. Kirurgisk behandling er ofte den mest effektive og endelige intervention. Holmium laser enucleation af prostata (HoLEP), en af de mest effektive kirurgiske procedurer for BPH, udføres transurethrally. Under operationen er den vigtigste og vanskeligste del at finde den kirurgiske kapsel af prostata, som er konsekvent at tanken om anatomiske kirurgi. Forskellige færdigheder kan være nødvendig i behandlingen af forskellige dele af prostata. HoLEP tendens til at være effektivt og sikkert med god hæmostatisk egenskaber, og stand til behandling af blære calculus, kan der være komplikationer af BPH. Teknikken er især velegnet til prostata af varierende mængder og størrelser. HoLEP præsenterer også visse ulemper, som en lang indlæringskurve og dyrt udstyr. Uanset hvad, kan denne metode være den "nye standard" og den fremragende metode for kirurgisk behandling af BPH.

Retrospektive data, indsamlet fra 2015 til 2016, stammer fra den kliniske database i vores afdeling. I alt 100 patienter behandlet for BPH blev indskrevet i undersøgelsen. Perioperative resultater var inkluderet: drift tid (OT), hæmoglobin nedgang efter kirurgi, Na+ variation, hospital ophold varighed, blære kunstvanding varighed og opfølgning data. Grundlæggende patient egenskaber blev også indsamlet under vores undersøgelse. Derudover blev kateterisation tid og indlæg...

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.

Her præsenterer vi en sikker og effektiv protokol, holmium laser enucleation af prostata, til behandling af benign prostatahyperplasi.

Kirurgisk behandling af Benign prostatahyperplasi: Holmium Laser Enucleation af prostata (HoLEP).

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

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

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