Benign prostsatic hypertrophy is a common disease of middle-aged and elderly men that necessitates surgical resection of the prostatic gland, and transurethral resection is the second most common surgical procedure in men over the age 65. This
geriatric
patient population generally carries grater anesthetic risk than the young because of greater prevalence of coexisting cardiovascular or pulmonary diseases. Futhermore, because transurethral resection carries a number of complications such as
bleeding
requiring transfusion, TURP syndrome, arrhythmia, hemolysis, coagulopathy, sepsis, bladder perforation, and pulmonary edema, transurethral resection of concern to anesthesiologists.
Thus, we had reviewed clinical records of 401 cases of benign prostatic hypertrophy and performed clinical and statistical analysis according to age, ASA physical status, preoperative abnormal laboratory findings, combined diseases, anesthetic
techniques, resection time of prostate, volume of irrigation fluid, weight of resected prostate, transfusion, intraoperative and postoperative complications.
@ES The results were as follows.
@EN 1) Of the 401 cases, 175 cases (43.6%) were 61-70 years of age.
2) The most common ASA physical status was class 2 (73.6%).
3) Of the operative methods, most common was TURP (89.5%).
4) Preoperative chest X-ray evaluation showed abnormalities in 167 cases (41.6%); 52 cases (31.1%) had hypertensive heart configuration, 40 cases (24.0%) had inactive pulmonary tuberculosis, and 39 case (23.4%) had pleural thickening.
5) Preoperative abnormal ECG findings were found in 150 cases (37.4%); 52 cases (34.7%) had LVH, 43 cases (28.7%) had heart block, and 35 cases (23.3%) had myocardial ischemia.
6) Preoperative pulmonary function test showed abnormalities in 101 cases (25.2%), most common abnormal finding was small airway obstruction disease (22.8%).
7) The associated diseases were 146 cases (36.4%) and most commonly associated disease was hypertension (36.3%).
8) The number of epidural anesthesia was performed in 218 cases (54.4%); general anesthesia, in 118 (29.4%) and spinal anesthesia, in 65 (16.2%). The duration f resection time was less than 1 hour in 315 cases (87.8%).
9) The mean value of the volume of irrigation fluid was 15.6±8.2L, and the mean value of weight of resected prostate was 22.4±16.9g.
10) Total number of intraoperative complications were 60 cases; 6 cases were ECG abnormalities, 32 cases were bleeding, and 12 cases were intraoperative hypotension. Postoperative complications were bleeding and acute myocardial infarction, but
there
was no death.
|