[Clinical application value of the endoscopic surveillance system in transurethral bipolar plasmakinetic resection of the prostate].

OBJECTIVE

To evaluate the clinical application of the endoscopic surveillance system (ESS) in transurethral bipolar plasmakinetic resection of the prostate (TUPKRP).

METHODS

We retrospectively analyzed 136 cases of TUPKRP performed with the assistance of ESS from September 2018 to March 2019. According to the prostate volume (PV), we divided the patients into a PV ≥ 60 ml and a PV < 60 ml group, and compared the surgery-related parameters between the two groups of patients.

RESULTS

Operations were successfully completed in all the 136 cases. Statistically significant differences were observed between the PV ≥ 60 ml and a PV < 60 ml groups in the operation time (［78.93 ± 28.63］ vs ［51.77 ± 14.85］ min, P < 0.05), intraoperative blood loss (［261.61 ± 204.25］ vs ［69.26 ± 61.13］ ml, P < 0.05) and absorption of the rinse fluid (［948.20 ± 656.00］ vs ［347.39 ± 256.53］ ml, P < 0.05), but not in the postoperative red cell count, levels of hemoglobin, hematocrit and ions, hospital stay, incidence of prostatic perforation or blood transfusion (P > 0.05). The patients also showed statistically significant differences between the baseline and postoperative parameters in red cell count (［4.62 ± 0.63］ vs ［4.31 ± 0.74］ ×1012/L, P < 0.05) and levels of hemoglobin (［141.83 ± 18.30］ vs ［135.20 ± 19.91］ g/L, P < 0.05), K+ (［4.01 ± 0.43］ vs ［3.92 ± 0.54］ mmol/L, P < 0.05) and Na+ (［141.90 ± 3.11］ vs ［139.42 ± 3.81］ mmol/L, P < 0.05), but not in the levels of Cl－ (［103.74 ± 9.32］ vs ［103.70 ± 4.50］ mmol/L, P > 0.05) and Ca2+ (［2.21 ± 0.13］ vs ［2.19 ± 0.21］ mmol/L, P > 0.05).

CONCLUSIONS

Large-volume absorption of rinse fluid may overburden the circulatory system and induce left ventricular failure, pulmonary edema or massive bleeding during PKRP for patients with PV ≥ 60 ml due to long operation time and rich blood supply in the hyperplasia gland. The endoscopic surveillance system can provide real-time data on the absorption of rinse fluid and bleeding, reduce complications, and improve surgical safety.