[Application of the concept of accelerated rehabilitation surgery in the perioperative period of robot-assisted laparoscopic radical prostatectomy].

OBJECTIVE: To explore the effect of the concept of accelerated rehabilitation surgery in the perioperative period of robot-assisted laparoscopic radical resection of prostate cancer. METHODS: A total of 100 patients with prostate cancer in our hospital from January 2022 to January 2023 were divided into control group and enhanced recovery after surgery (ERAS) group by random number table Methods Robot-assisted laparoscopic radical prostatectomy was performed in both groups. ERAS group was treated with accelerated surgical nursing mode, while the control group was treated with traditional perioperative nursing. Operation-related indicators, anxiety, depression, pain, postoperative complications and nursing satisfaction of the two groups were compared. RESULTS: 100 patients were successfully operated. Compared with the control group, the operative time and intraoperative blood loss in ERAS group had no statistical significance (P>0.05)，the postoperative hospitalization time was shortened and the intestinal ventilation time was advanced, with statistical significance (P< 0.05). Anxiety, depression and pain scores in ERAS group were lower than those in control group, with statistical significance (P< 0.05), while postoperative complications and nursing satisfaction in ERAS group were better than those in control group, with statistical significance (P< 0.05). CONCLUSION: ERAS concept combined with robot-assisted laparoscopic radical prostatectomy has the advantages of less trauma and strong stability, which can significantly shorten the length of hospital stay, reduce postoperative complications, accelerate patient recovery and improve nursing satisfaction.

[Application of 1470 nm semiconductor laser in the treatment of benign prostatic hyperplasia in ultra-aged patients].

OBJECTIVE: To investigate the clinical effect and safety of transurethral 1470 nm semiconductor laser vaporization and cutting in the treatment of super high age and high risk benign prostatic hyperplasia. METHODS: The clinical data of 38 patients with super-high-risk prostate who underwent transurethral surgery in our hospital from April 2016 to December 2017 were retrospectively analyzed. All patients had obvious progressive dysuria. The diagnosis of benign prostatic hyperplasia was confirmed by urinary color Doppler ultrasound, anal finger examination, PSA, prostate biopsy, etc., and prostate cancer was excluded. Each patient was aged ≥85 years old and combined with one or more types. Senile basic diseases such as diabetes, hypertension, coronary heart disease, emphysema, sequelae of cerebral infarction, etc. The patients were randomly divided into two groups. The observation group was treated with transurethral 1470 nm semiconductor laser vaporization and the control group was treated with transurethral plasma electrotomy. To observe the changes of vital signs, bleeding, duration of surgery, postoperative bladder irrigation time, urinary catheter retention time, and changes of hemoglobin before and after surgery. Surgical safety. The international prostate symptom score (IPSS), quality of life score (QoL), maximum urinary flow rate (Qmax), and post-void residual urine volume (PVR) were evaluated 2 months after surgery and compared with preoperative evaluation to evaluate the surgical outcome. RESULTS: All 38 operations were successfully completed.The vital signs of the patients were stable during the operation. The average operation time of the observation group and the control group was (79.6±24.7 vs 69.5±19.8) min, P>0.05. The hemoglobin decreased by (6.9±3.0) g/L vs (13.2±4.0) g/L， after operation.P<0.05; postoperative bladder irrigation time (14.7±2.8 vs 23.5±5.3)h, P<0.05; average postoperative urinary catheter retention time (3.8±0.4 vs 5.7±0.9)d, P<0.05; average postoperative hospital stay (5.3±1.1 vs 7.2±1.9)d, P<0.05; all patients were followed up for 2 months, IPSS, QoL, Qmax, PVR and other indicators were significantly improved compared with preoperative, no major bleeding, urinary incontinence, cardiopulmonary failure and Significant urinary tract irritation symptoms occur. CONCLUSION: Compared with plasma electric resection, transurethral 1470 nm semiconductor laser treatment of benign prostatic hyperplasia has the advantages of high safety and remarkable effect, especially suitable for patients with high age and high risk.