経腹的超音波ガイドによる経尿道的前立腺切除術

TRANSURETHRAL RESECTION OF PROSTATE USING TELEVISION IMAGES OF ENDOSCOPY AND TRANSABDOMINAL ULTRASONOGRAPHY

　経尿道的前立腺切除術をより効果的かつ安全に行うために経腹的に得られた前立腺超音波画像と内視鏡画像の両方を見ながら，35名の患者に対して行った．前立腺被膜と腺腫の区別は明瞭となり，切除面は高エコー像を示した．超音波画像より切除片は効果的に除去できた．被膜の穿孔部位と溢流灌流液は容易に分かった．切除量は術前超音波画像から得られた推定腺腫重量にほぼ一致し，尿流量率は97％の患者で改善した．この方法により，経尿道的前立腺切除術を効果的に，安全に行える．特に手技の習得に有用である．

Observing both television monitors of endoscopy and transabdominal ultrasonographic images, weperformed transurethral resection of prostate in 35 patients. The prostatic capsule was clearly distinguishedfrom adenoma. The resection plane produced a hyperechoic image. Easy positioning of the sheath to resectedchips enabled us to evacuate them effectively. A perforated capsule and extravasated fluid were clearlyvisualized. The weight of the resected specimens was almost equal to that estimated by preoperativeultrasonography. Postoperative uroflowmetry showed an improved flow rate in 97% of patients.