دراسة مقارنة للمضاعفات الباكرة لتجريف الموثة عبر الإحليل (TURP)، وبين استئصال الضخامة الموثية الجراحي المفتوح.
Abstract
شملت الدراسة 75 مريضاً شُخّص لهم فرط تصنع الموثة الحميد، وعولجوا علاجاً جراحياً في مشفى الأسد الجامعي بجامعة تشرين في الفترة الممتدة بين شهري آب 2009 و آب 2010 عولج منهم 33 مريضاً بالتجريف عبر الإحليل و42 مريضاً بالجراحة المفتوحة فوق العانة. وتهدف الدراسة إلى إلقاء الضوء على واقع هذا العلاج الجراحي بتقنيتيه، ومضاعفاته الباكرة.
كانت نسبة الوفيات خلال مدة المتابعة عند مرضى الجراحة المفتوحة 2,38% مقابل 0% في التجريف كما كان هناك فرق واضح في المضاعفات القريبة بين التقنيتين، كإعادة الجراحة بسبب النزف (4,76% في الجراحة المفتوحة مقابل 0% في التجريف)، ونقل الدم (69,04% مقابل 33,33%)، وسلس البول (21,42% مقابل 0%) وكذلك مدة الإستشفاء بعد الجراحة (6,8 يوم مقابل 2,7 يوم للتجريف).أكدت الدراسة على أن تجريف الموثة عبر الإحليل هو التقنية ذات المضاعفات الأقل ودعمت مقولة أن التجريف أصبح القاعدة الذهبية في علاج الضخامة الموثية وأكدت ضرورة حصر نقل الدم بالاستطباب المناسب، كما أكدت على ضرورة إدخال التقنيات الحديثة الأقل غزوا كاللايزر، والتجريف ثنائي القطب للوصول إلى العلاج الأمثل للضخامة الموثية الحميدة.
This study includes 75 cases of Benign Prostatic Hyperplasia (BPH) treated in AL-ASSAD University Hospital between August 2009 and August 2010, 33 of cases were treated with Transurethral Resection of the Prostate (TURP) and the other 42 cases were treated with open Surgical Suprapubic Prostatectomy (SPP). The aim of the study is to evaluate the surgical treatment of BPH and its early postoperative complications.
The near mortality rate of patients subjected to Suprapubic Prostatectomy was 2,38% versus 0% for TURP and the rates of near complications of SSP was clearly more than that of TURP such as reoperation because of bleeding (4,76 for SSP vs. 0% for TURP), blood transfusion (69,04% vs. 33,33), incontinence (21,42 vs.0%) and hospitalization period (6.8 day vs. 2,7 day). The comparison of SSP by TURP yields that TURP is of lower complication׳s rates, and assured that TURP is to be the golden rule in treatment of BPH and assured the necessity of restriction of blood transfusion to the cases of real indications and the necessity of making new techniques such as bipolar and laser therapy a daily practice in our hospital to reach the optimal surgical therapy of BPH.
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