TY - JOUR
T1 - Comparison Between Two Different En Bloc Thulium Laser Enucleation of the Prostate
T2 - Does Technique Influence Complications and Outcomes?
AU - Castellani, Daniele
AU - Saredi, Giovanni
AU - Pirola, Giacomo Maria
AU - Gasparri, Luca
AU - Pavia, Maria Pia
AU - Ambrosini, Francesca
AU - Berti, Lorenzo
AU - Sembenini, Federico
AU - Dellabella, Marco
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Objective: To evaluate whether 2 similar en bloc thulium laser enucleation of the prostate (ThuLEP) techniques can influence surgical complications and outcomes. Material: Within 2 institutional databases 164 men who underwent 2 different en bloc ThuLEP techniques were compared using propensity scores. With the first technique prostatic lobes were all enucleated en bloc, whereas, with the second the median lobe was enucleated first and the lateral lobes were enucleated en bloc thereafter. All patients were evaluated at baseline and 6 months after surgery with PSA, Qmax, and self-administrated IPSS. Operative data and 30-day postoperative complications were gathered. Results: Surgical time and 24-hour blood loss were similar between 2 groups (55 vs 55 minutes, P.97288; −0.9 vs −1.3 g/dL, P.112 respectively). Median hospital stay after surgery was 3 days in both groups (P.3251). IPSS and Qmax improved equally in both groups (median 3 vs 3, P.941; 19.17 vs 20.63 mL/s, P.8232 respectively). Early complications were mild to moderate (Clavien I 12.2% vs 12.2%; Clavien II 3.6% vs 4.8 4 %; Clavien IIIb 1.2% vs 2.4%). Conclusion: Our results show that en bloc ThuLEP approaches appear feasible, have similar complications and outcomes and can be considered surgeon-independent techniques. En bloc ThuLEP may be proposed even for laser-naïve urologists as an alternative to the original 3-lobe technique.
AB - Objective: To evaluate whether 2 similar en bloc thulium laser enucleation of the prostate (ThuLEP) techniques can influence surgical complications and outcomes. Material: Within 2 institutional databases 164 men who underwent 2 different en bloc ThuLEP techniques were compared using propensity scores. With the first technique prostatic lobes were all enucleated en bloc, whereas, with the second the median lobe was enucleated first and the lateral lobes were enucleated en bloc thereafter. All patients were evaluated at baseline and 6 months after surgery with PSA, Qmax, and self-administrated IPSS. Operative data and 30-day postoperative complications were gathered. Results: Surgical time and 24-hour blood loss were similar between 2 groups (55 vs 55 minutes, P.97288; −0.9 vs −1.3 g/dL, P.112 respectively). Median hospital stay after surgery was 3 days in both groups (P.3251). IPSS and Qmax improved equally in both groups (median 3 vs 3, P.941; 19.17 vs 20.63 mL/s, P.8232 respectively). Early complications were mild to moderate (Clavien I 12.2% vs 12.2%; Clavien II 3.6% vs 4.8 4 %; Clavien IIIb 1.2% vs 2.4%). Conclusion: Our results show that en bloc ThuLEP approaches appear feasible, have similar complications and outcomes and can be considered surgeon-independent techniques. En bloc ThuLEP may be proposed even for laser-naïve urologists as an alternative to the original 3-lobe technique.
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U2 - 10.1016/j.urology.2018.05.024
DO - 10.1016/j.urology.2018.05.024
M3 - Article
C2 - 29894773
AN - SCOPUS:85051644667
VL - 119
SP - 121
EP - 126
JO - Urology
JF - Urology
SN - 0090-4295
ER -