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Objective <p>To determine impact factors affecting intraoperative blood loss and fluid absorption by utilizing a novel endoscopic surgical monitoring system (ESMS) for objective quantification in high-risk benign prostatic hyperplasia (BPH) patients undergoing transurethral plasmakinetic resection of the prostate (PK-TURP).</p> Methods <p>This prospective cohort study enrolled 512 high-risk BPH patients undergoing PK-TURP. The ESMS was employed to monitor blood loss and fluid absorption in real-time and non-invasively during the surgery. Univariable and multivariable linear and logistic regression analyses were used to identify factors associated with blood loss (and &gt; 300&#xa0;ml) and fluid absorption (and &gt; 1000&#xa0;ml).</p> Results <p>Multivariable analyses showed prostate volume, operation time, resected tissue weight, venous sinus opening and present smoking (10-20cigs/d, &gt; 20cigs/d) were independent risk factors of blood loss and fluid absorption (all <i>P</i> &lt; 0.05). Surgical capsule perforation was a significant risk factor for fluid absorption (and &gt; 1000&#xa0;ml) (B:100.47, <i>P</i>=0.008; OR:2.917, <i>P</i>=0.015). Preoperative finasteride treatment (7days-3months, &gt;3months) and surgeon’s experience (50–250 procedures, 250–500 procedures, &gt; 500 procedures) were factors associated with lower odds of blood loss and fluid absorption (all <i>P</i> &lt; 0.05).</p> Conclusion <p>Prostate volume, operation time, resected tissue weight, venous sinus opening, and present smoking (10-20cigs/d, &gt; 20cigs/d) increase the risk of blood loss and fluid absorption during PK-TURP in high-risk patients. Preoperative finasteride treatment (7days-3months, &gt;3months) and surgeon’s experience (50–250 procedures, 250–500 procedures, &gt; 500 procedures) reduce these risks, while surgical capsule perforation significantly increases fluid absorption risk. The ESMS represents an innovative tool for real-time blood loss and fluid absorption monitoring, enabling precision identification of impact factors and enhancing perioperative decision-making.</p>

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The endoscopic surgical monitoring system-guided impact factors exploring of blood loss and fluid absorption during plasmakinetic TURP: a prospective study in high-risk BPH patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月18日

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  • Qi Jin,
  • Jiaodi Zhang,
  • Guilin Wang,
  • Yunxin Zhang,
  • Zhenxing Zhai,
  • Aizhang Yi,
  • Yongqiang Ding,
  • Jiangtao Bai,
  • Qihui Zheng,
  • Wenjun Jin,
  • Luyang Zhang,
  • Haitao Jia,
  • Ting Guo,
  • Zhilong Dong,
  • Junqiang Tian,
  • Jun Mi,
  • Zhiping Wang

摘要

Objective

To determine impact factors affecting intraoperative blood loss and fluid absorption by utilizing a novel endoscopic surgical monitoring system (ESMS) for objective quantification in high-risk benign prostatic hyperplasia (BPH) patients undergoing transurethral plasmakinetic resection of the prostate (PK-TURP).

Methods

This prospective cohort study enrolled 512 high-risk BPH patients undergoing PK-TURP. The ESMS was employed to monitor blood loss and fluid absorption in real-time and non-invasively during the surgery. Univariable and multivariable linear and logistic regression analyses were used to identify factors associated with blood loss (and > 300 ml) and fluid absorption (and > 1000 ml).

Results

Multivariable analyses showed prostate volume, operation time, resected tissue weight, venous sinus opening and present smoking (10-20cigs/d, > 20cigs/d) were independent risk factors of blood loss and fluid absorption (all P < 0.05). Surgical capsule perforation was a significant risk factor for fluid absorption (and > 1000 ml) (B:100.47, P=0.008; OR:2.917, P=0.015). Preoperative finasteride treatment (7days-3months, >3months) and surgeon’s experience (50–250 procedures, 250–500 procedures, > 500 procedures) were factors associated with lower odds of blood loss and fluid absorption (all P < 0.05).

Conclusion

Prostate volume, operation time, resected tissue weight, venous sinus opening, and present smoking (10-20cigs/d, > 20cigs/d) increase the risk of blood loss and fluid absorption during PK-TURP in high-risk patients. Preoperative finasteride treatment (7days-3months, >3months) and surgeon’s experience (50–250 procedures, 250–500 procedures, > 500 procedures) reduce these risks, while surgical capsule perforation significantly increases fluid absorption risk. The ESMS represents an innovative tool for real-time blood loss and fluid absorption monitoring, enabling precision identification of impact factors and enhancing perioperative decision-making.