A Comparative Study Of The Risk Of Thromboembolism In The Peri-Operative Preiod HoLEP And TURP

PURPOSE:By detecting the index of coagulation and anticoagulation,fibrinolysis and anti-fibrinolysis,as well as routine examination of coagulation function to compare the risk of thromboembolism postoperation between the Holmium laser enucleation of the prostate and Transurethral resection prostate.METHODS:(1)Retrospective statistics and analysis the medical records of the patients who received TURP or HoLEP from 2013.01 to 2017.03 in our hospital,compared the two groups of patients after the occurrence of thrombosis-related events.(2)We identified 70 cases of BPH from the Second Affiliated Hospital of Zhejiang University.For patients enrolled detailed medical history and physical examination and specialist medical record system,improve prostate B ultrasound,prostate specific antigen(PSA)measurement,and the routine examination before surgery.Study parameters were measured:before the start of surgery,after 1 day,after 3 days,respectively coagulation monitoring routine examination of patients,PF 1 + 2 and TAT,PAI-1 and t-PA.Postoperative observation and follow-up:observation and recording of postoperative complications of patients,and in patients with routine follow-up in January after surgery.RESULTS:(1)Between 2013 and 2016,there were 396 cases of patients with TURP surgery in our hospital.Among them,there were 3 cases of venous thrombosis with lower extremity venous thrombosis and pulmonary infarction.There were 373 cases of patients with HoLEP surgery.Among them,there were 1 cases of venous thrombosis with lower extremity venous thrombosis,without pulmonary infarction.(2)In the TURP group,3 patients had a history of cerebral infarction or cerebrovascular disease.In the HoLEP group,2 patients had a history of myocardial infarction.The rest had no history of cerebrovascular and venous thrombosis or pulmonary embolism,no coagulation disorder,no antiplatelet or anticoagulant drugs,prostate specific antigen(PSA)determination in the normal range,the final inclusion of effective cases in 65 cases,of which 32 cases of TURP,33 cases of HoLEP.There was no significant difference between the two groups(P>0.05)before surgery.At the first day after the surgery,There was no significant difference between APTT,TT,FIB,F1+ 2,TAT and t-PA of the two groups(P>0.05).There was significant difference of PAI-1(P<0.05).At the third day after the surgery,There was no significant difference between the two groups between APTT,TT,F1 + 2,TAT and t-PA(P>0.05).There was no significant difference between the two groups of FIB and PAI-1(P<0.05).There were no thromboembolic events in 65 patients after 2 weeks and 1 month follow-up.Conclusion:The hypercoagulable state of blood in patients with HoLEP is lower than that of TURP,and the risk of thromboembolic events is relatively low.CONCLUSIONS:Compared with HoLEP and TURP,patients with HOLEP had a lower risk of thromboembolism after surgery.