Absorption of irrigation fluid during XPS™ GreenLight laser vaporization of the prostate: results from a prospective breath ethanol monitoring study
| العنوان: | Absorption of irrigation fluid during XPS™ GreenLight laser vaporization of the prostate: results from a prospective breath ethanol monitoring study |
|---|---|
| المؤلفون: | Alexander Müller, Cédric Poyet, Salome Meyer, Marian S. Wettstein, Thomas Hermanns, Tullio Sulser, Marko Kozomara, Etienne Xavier Keller, Christian D. Fankhauser, Nico C. Grossmann |
| المساهمون: | University of Zurich, Hermanns, Thomas |
| المصدر: | World Journal of Urology. 34:1261-1267 |
| بيانات النشر: | Springer Science and Business Media LLC, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | 2748 Urology, Male, medicine.medical_specialty, Urology, Bicarbonate, medicine.medical_treatment, Ethanol Intraoperative complications Laser therapy Prostate Therapeutic irrigation, 030232 urology & nephrology, Therapeutic irrigation, 610 Medicine & health, Absorption (skin), Sodium Chloride, Hematocrit, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Prostate, medicine, Humans, Prospective Studies, Intraoperative Complications, Therapeutic Irrigation, Lead (electronics), Prospective cohort study, Aged, Aged, 80 and over, Prostatectomy, Ethanol, medicine.diagnostic_test, business.industry, Middle Aged, Absorption, Physiological, Surgery, 10062 Urological Clinic, medicine.anatomical_structure, Breath Tests, chemistry, 030220 oncology & carcinogenesis, Laser Therapy, business |
| الوصف: | To assess whether and to what extent irrigation fluid absorption occurs during laser vaporization (LV) of the prostate using the 180 W XPS™ GreenLight laser. This prospective investigation was performed in a tertiary care center with a consecutive series of patients undergoing 180 W LV of the prostate. Intraoperative irrigation was performed with isotonic saline containing 1 % ethanol. The volume of irrigation fluid absorption was calculated from periodically performed breath ethanol measurements during LV. Additionally, intraoperative changes in biochemical and hematological blood parameters were assessed. Positive breath ethanol tests were detectable in 22 of 54 patients. The median absorption volume in these patients was 950 ml (range 208–4579 ml). Ten patients absorbed more than 2000 ml. Absorbers had smaller prostates, more capsular perforations and injuries to venous sinuses, and more total energy was applied with higher output power. Five patients had transient symptoms potentially related to fluid absorption. A significant drop in hemoglobin, hematocrit, venous pH and bicarbonate and an increase in chloride were detectable in the absorber group. These changes were significantly different in the non-absorber group. Absorption of irrigation fluid did occur in a relevant proportion of patients undergoing XPS™ GreenLight LV. High-volume absorption (≥2000 ml), which might be clinically relevant, was detectable in almost 20 % of all procedures. Absorption of saline irrigation fluid does not result in a classical TUR syndrome, but fluid and chloride overload can lead to serious complications, particularly in cardiovascular high-risk patients. Thus, patients with symptoms potentially related to fluid absorption should be monitored carefully. |
| وصف الملف: | Wettstein_WorldJUrol_2016.pdf - application/pdf; Wettstein_WJU_2016.pdf - application/pdf |
| تدمد: | 1433-8726 0724-4983 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::817d02e7a746fca5eec7b837f9c19796Test https://doi.org/10.1007/s00345-016-1766-xTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....817d02e7a746fca5eec7b837f9c19796 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14338726 07244983 |
|---|