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Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate
Jeong, Chang Wook; Oh, Jin Kyu; Cho, Min Chul; Bae, Jung-Bum; Oh, Seung-June.
  • Jeong, Chang Wook; Seoul National University Hospital. Department of Urology. Seoul. KR
  • Oh, Jin Kyu; Seoul National University Hospital. Department of Urology. Seoul. KR
  • Cho, Min Chul; Seoul National University Hospital. Department of Urology. Seoul. KR
  • Bae, Jung-Bum; Seoul National University Hospital. Department of Urology. Seoul. KR
  • Oh, Seung-June; Seoul National University Hospital. Department of Urology. Seoul. KR
Int. braz. j. urol ; 38(3): 362-372, May-June 2012. graf, tab
Artigo em Inglês | LILACS | ID: lil-643035
ABSTRACT

PURPOSE:

To appraise the evaluation methods for learning curve and to analyze the non-mentor-aided learning curve and early complications following the holmium laser enucleation of the prostate. MATERIALS AND

METHODS:

One-hundred and forty (n=140) consecutive patients who underwent HoLEP from July 2008 to July 2010 by a single surgeon (SJO) were enrolled. Perioperative clinical variables, including enucleation time, morcellation time, enucleation ratio (enucleation weight/transitional zone volume), enucleation efficacy (enucleated weight/enucleation time), enucleation ratio efficacy (enucleation ratio/enucleation time), and early complication rate were analyzed.

RESULTS:

Mean prostate volume was 62.7 mL (range 21-162) and preoperative International Prostate Symptom Score (IPSS) was 19.0 (4-35). Mean enucleation time and morcellation time were 49.9±23.8 (S.D.) min and 11.0±9.7 min, respectively. Median duration of postoperative indwelling catheter was 1 (1-7) day and median hospital stay was 1 (1-6) day. There were a total of 31 surgery-related complications in 27 patients (19.3%), and all were manageable. There was an increasing trend of enucleation efficacy in the first 50 cases. However, enucleation efficacy was linearly correlated with the prostate size (correlation coefficients, R=0.701, p<0.001). But, enucleation ratio efficacy could eliminate the confounding effect of the prostate size (R=-0.101, p=0.233). The plateau of enucleation ratio efficacy was reached around the twenty-fifth case.

CONCLUSIONS:

Our results demonstrated that the operative learning curve plateau is reached after about 25 cases. We propose that a more appropriate parameter for estimating the operative learning curve is enucleation ratio efficacy, rather than enucleation efficacy.
Assuntos


Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Próstata / Prostatectomia / Hiperplasia Prostática / Lasers de Estado Sólido / Curva de Aprendizado Tipo de estudo: Estudo prognóstico / Fatores de risco Limite: Idoso / Humanos / Masculino Idioma: Inglês Revista: Int. braz. j. urol Assunto da revista: Urologia Ano de publicação: 2012 Tipo de documento: Artigo País de afiliação: Coréia do Sul Instituição/País de afiliação: Seoul National University Hospital/KR

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Próstata / Prostatectomia / Hiperplasia Prostática / Lasers de Estado Sólido / Curva de Aprendizado Tipo de estudo: Estudo prognóstico / Fatores de risco Limite: Idoso / Humanos / Masculino Idioma: Inglês Revista: Int. braz. j. urol Assunto da revista: Urologia Ano de publicação: 2012 Tipo de documento: Artigo País de afiliação: Coréia do Sul Instituição/País de afiliação: Seoul National University Hospital/KR