Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Cocci Andrea, Pezzoli Marta, Bianco Fernando, Blefari Franco, Bove Pierluigi, Cornud Francois, De Rienzo Gaetano, Destefanis Paolo, Di Trapani Danilo, Giacobbe Alessandro, Giovanessi Luca, Laganà Antonino, Lughezzani Giovanni, Manenti Guglielmo, Muto Gianluca, Patelli Gianluigi, Pinzi Novello, Regusci Stefano, Russo Giorgio I, Salamanca Juan I M, Salvi Matteo, Silvestri Luigi, Verweij Fabrizio, Walser Eric, Bertolo Riccardo G, Iacovelli Valerio, Bertaccini Alessandro, Marchiori Debora, Davila Hugo, Ditonno Pasquale, Gontero Paolo, Iapicca Gennaro, M De Reijke Theo, Ricapito Vito, Pellegrini Pierluca, Minervini Andrea, Serni Sergio, Sessa Francesco
Аннотация
METHODS: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.
RESULTS: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.
CONCLUSION: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.