Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment
Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment
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DOI：
10.1038/aja.2009.17
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发表时间：
2009-04-01
影响因子：
2.9
通讯作者：
Xia, Shu-Jie
中科院分区：
文献类型：
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作者：
Xia, Shu-Jie
两微米（铥）激光前列腺-橘子切除术技术（TmLRP-TT）是一种经尿道手术，使用铥激光纤维从手术包膜上解剖整个前列腺叶，类似于剥橘子。我们最近报道了初步结果。下面我们详细介绍一下这个过程。在连续波模式下使用70 w， 2 μ m（铥）激光器。我们从睾丸的水平到膀胱颈部做了一个横向切口，使切除足够深到手术包膜，并将前列腺切除成小块，就像剥橘子一样。当我们切除前列腺时，碎片被汽化，足够小，可以通过切除镜鞘排出，并且不需要使用机械组织粉碎器。铥激光良好的止血效果保证了TmLRP-TT的安全性。没有病人需要输血。术中使用生理盐水冲洗，无经尿道切除综合征发生。所有病例在拔管后膀胱出口梗阻均明显消除。我们设计了橘红色技术，并证明它是最适合使用铥激光治疗良性前列腺增生（BPH）的程序。该手术比标准手术时间短，安全，结合了高效的切割和快速的有机汽化，从而显示了铥光纤激光治疗BPH的巨大优势。在1年的随访中，它已被证明与经尿道前列腺切除术（TURP）一样安全有效。
Two-micron (thulium) laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. We recently reported the primary results. Here we introduce this procedure in detail. A 70-W, 2-mu m (thulium) laser was used in continuous-wave mode. We joined the incision by making a transverse cut from the level of the verumontanum to the bladder neck, making the resection sufficiently deep to reach the surgical capsule, and resected the prostate into small pieces, just like peeling a tangerine. As we resected the prostate, the pieces were vaporized, sufficiently small to be evacuated through the resectoscope sheath, and the use of the mechanical tissue morcellator was not required. The excellent hemostasis of the thulium laser ensured the safety of TmLRP-TT. No patient required blood transfusion. Saline irrigation was used intraoperatively, and no case of transurethral resection syndrome was observed. The bladder outlet obstruction had clearly resolved after catheter removal in all cases. We designed the tangerine technique and proved it to be the most suitable procedure for the use of thulium laser in the treatment of benign prostatic hyperplasia (BPH). This procedure, which takes less operative time than standard techniques, is safe and combines efficient cutting and rapid organic vaporization, thereby showing the great superiority of the thulium fiber laser in the treatment of BPH. It has been proven to be as safe and efficient as transurethral resection of the prostate (TURP) during the 1-year follow-up.