BJU international · 2020
Critical analysis of a multicentric experience with holmium laser enucleation of the prostate for benign prostatic hyperplasia: outcomes and complications of 10 years of routine clinical practice.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Romero-Otero Javier, García-Gómez Borja, García-González Lucía, García-Rojo Esther, Abad-López Pablo, Justo-Quintas Juan, Duarte-Ojeda José, Rodríguez-Antolín Alfredo
Аннотация
OBJECTIVE: To assess the perioperative outcomes of holmium laser enucleation of the prostate (HoLEP) in real-life practice and investigate the factors influencing the safety and effectiveness of the technique.
PATIENTS AND METHODS: Critical analysis of patients with benign prostate hyperplasia (BPH) treated with HoLEP over 10 years of routine practice in three hospitals. Analysed variables included: preoperative characteristics (prostate size, active antiplatelet/anticoagulant therapy, blood parameters. prostate-specific antigen (PSA) level, maximum urinary flow rate [Qmax ], and International Prostate Symptom Score [IPSS]), intraoperative variables (operation time, concomitant removal of bladder calculi, and complications), early postoperative outcomes (change in blood parameters, catheterisation time, and hospital stay), and 12-month follow-up outcomes (change in IPSS, PSA level, and Qmax ).
RESULTS: The analysis included 963 patients, aged 48-91 years, with a mean (range) prostate size of 91 (35-247) mL. The mean (sd) operation time was 77 (29) min, and the hospital stay and catheterisation time were 4 (2) and 1.3 (2) days, respectively. In all, 56 patients (5.6%) required concomitant removal of bladder calculi and 36 (3.7%) were converted to open prostatectomy or transurethral resection of the prostate due to intraoperative complications. Patients had a significant decrease in haemoglobin and haematocrit, but no differences were seen between patients with and without anticoagulant/antiplatelet therapy and those with prostates ≥ and <100 mL. The concomitant removal of bladder calculi and having a prostate ≥100 mL resulted in a longer operation time, but did not influence the safety and effectiveness outcomes.
CONCLUSIONS: HoLEP is suitable for real-life patients with BPH, irrespective of the presence of active treatment with anticoagulant/antiplatelet, bladder lithiasis or a prostate ≥100 mL.
PATIENTS AND METHODS: Critical analysis of patients with benign prostate hyperplasia (BPH) treated with HoLEP over 10 years of routine practice in three hospitals. Analysed variables included: preoperative characteristics (prostate size, active antiplatelet/anticoagulant therapy, blood parameters. prostate-specific antigen (PSA) level, maximum urinary flow rate [Qmax ], and International Prostate Symptom Score [IPSS]), intraoperative variables (operation time, concomitant removal of bladder calculi, and complications), early postoperative outcomes (change in blood parameters, catheterisation time, and hospital stay), and 12-month follow-up outcomes (change in IPSS, PSA level, and Qmax ).
RESULTS: The analysis included 963 patients, aged 48-91 years, with a mean (range) prostate size of 91 (35-247) mL. The mean (sd) operation time was 77 (29) min, and the hospital stay and catheterisation time were 4 (2) and 1.3 (2) days, respectively. In all, 56 patients (5.6%) required concomitant removal of bladder calculi and 36 (3.7%) were converted to open prostatectomy or transurethral resection of the prostate due to intraoperative complications. Patients had a significant decrease in haemoglobin and haematocrit, but no differences were seen between patients with and without anticoagulant/antiplatelet therapy and those with prostates ≥ and <100 mL. The concomitant removal of bladder calculi and having a prostate ≥100 mL resulted in a longer operation time, but did not influence the safety and effectiveness outcomes.
CONCLUSIONS: HoLEP is suitable for real-life patients with BPH, irrespective of the presence of active treatment with anticoagulant/antiplatelet, bladder lithiasis or a prostate ≥100 mL.