Madigan前列腺切除术的临床应用评价  

Evaluation of the clinical application of Madigan prostatectomy

作　　者：武立新[1] 吴刚[1] 

机构地区：[1]安徽合肥市第三人民医院泌尿外科,安徽合肥230032

出　　处：《安徽医药》2008年第11期1060-1061,共2页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨Madigan前列腺切除术的临床效果，适应范围，及在当今前列腺外科手术中的价值。方法对24例有症状的良性前列腺增生（BPH）患者行Madigan前列腺切除术，平均年龄73岁，病程6个月～5年，平均前列腺体积58ml，中叶增生13例。合并高血压3例，冠心病2例，慢支2例，脑血管病2例。并发尿潴留11例，膀胱结石2例。术中根据情况行膀胱造瘘或不造瘘，术后保留尿管4～13d：结果手术时间50～145min，平均98win，1例术中发生耻骨后静脉丛破裂出血而改行经膀胱手术，1例术后第4d发生大量血尿行开放止血。1例术后病理诊断为前列腺癌，进一步行去势手术。其余21例手术过程顺利。随访3～5个月，所有病例术后排尿满意。结论Madigan前列腺切除术保留尿道生理结构完整性，具有术后出血少，恢复快等优点，但应正确掌握指征，合理应用，对腺体过大，中叶增生明显，局部炎症粘连者应慎重选用。Madigan前列腺切除术是前列腺增生外科治疗的一种补充方式，在适当的条件下应用才能发挥其优点。Aim To discuss the clinical effect,range, of application and the position of the Madigan prostatectomy. Method A total of 24 patients with benign prostatic hyperplasia （BPH） were subjected to Madigan prostatectomy in open prostatectomy surgery. The average age of these patients was 73. Duration of disease ranged from 6 months to 5 years. The average prostate volume was 58 ml ,among which 13 were middle lobe hyperplasia. Of these 24 patients,3 had high blood pressure,2 coronary heart disease,2 chronic brochitis,another 2 brain blood vessel disease,ll acute urinary retention,2 vesical calculus. Cystostomy was performed when necessary the indwelling catheters were removed in 4 to 13 days postoperatively. Results The operation time ranged from 50 to 145 minutes,and the mean operative time was 98 minutes. One case was transferred to suprapubic prostatectomy due to massive hemorrhage from retropubic venous plex. Another was diagnosed prostatic carcinoma pathologically after operation and was performed with bilateral orchiectomy. The operations of the other 21 patients were performed successfully and were followed up for 3 to 5 months,with a much satisfactory voiding results. Conclusion Madigan prostatectomy has the following advantages ：urethral remaining intact ,less bleeding and quick recovery. But proper consideration should be given to the patients with overlarge adenoma. Patients with the prostatic middle lobe hyperplasia and chronic inflamation should be applied with precaution. In a word,it is an important way to deal with prostatic hyperplasia.

关 键 词：前列腺增生 手术治疗 保留尿道 

分 类 号：R699[医药卫生—泌尿科学]