Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate
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 ANDMETHODS:
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.
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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