1976 Volume 67 Issue 10 Pages 876-880
Complete stopping of bleeding during and after operation is considerably difficult in prostatectomy. Benign prostatic hyperplasia is not infrequent among older males. More careful attention is needed during operation and rehabilitation than with young patients because of the poor risk. It is very important, therefore, that to control the bleeding during and after operation.
The prostate has a special organ in the physiology of fibrinolytic system. It is well known that the surgical capsule of the prostate has a greater contents of tissue plasminogen activator, and severe, prolonged, profuse bleeding or oozing are chiefly caused by increase of fibrinolytic activity in blood at the manipulation of the surgical capsule of the prostate during prostatectomy.
In the present paper, studies on prostatectomy and three kinds of anesthetic methods are reported. Between 1970 and 1972, 53 consecutive prostatectomies were performed by Millin's method (30 cases) and vesico-capsular technique (23 cases) under general anesthesia (nitrous oxide-fluothane), spinal block or epidural block. The comparative evaluations in three anesthetic methods were in number of case, age, volume of blood loss during operation, operating time and postoperative stay.
The age of patients ranged from 45 to 87 years and 41 cases (80%) were from 61 to 80 years of age. The least blood loss on the average was 339.6g of spinal cases. There was no significant difference in postoperative stays.
The pathogenesis of the profuse bleeding or oozing during and/or after prostatectomy is discussed by reviewing the literatures together with our experiment.
In conclusion, by our studies it was proved that the suitable method of anesthesia for prostatectomy was spinal block because of the least blood loss during operation and the shortest operating time.
