Analysis of operator learning curve of prostatic artery embolization for prostatic hyperplasia / 中国介入影像与治疗学

ABSTRACT

Objective To analyze the operator learning curve of prostatic artery embolization (PAE) in treatment of prostatic hyperplasia (PH). Methods: Data of the first to 60th PH patients treated with PAE by the same operator having more than 5 years' experiences of peripheral vascular interventional therapy were retrospectively analyzed. The patients were divided into groups A, B and C according to the treatment order (each n=20). PAE operation time, intraoperative X-ray exposure time and post-operation hospitalization were compared among groups. International prostate symptom score (IPSS) and quality of life score (QOL), prostate volume, maximum flow rate (Qmax) and post void residual (PVR) before and after operation were analyzed. Results: There was no statistical difference of prostate volume, IPSS score, QOL score, Qmax nor PVR among three groups before PAE (all P>0.05).There were significantly statistical differences of operation time and intraoperative X-ray exposure time (F=32.74, 13.57, both P<0.01) among 3 groups. Pairwise comparison showed the operation time and intraoperative X-ray exposure time in group A were significantly longer than those in group B (both P<0.01) and group C (both P<0.01), while the differences between group B and C were not statistical (P=0.22, 0.30). No statistical difference of post-operation hospitalization was found among 3 groups (F=0.17, P=0.84). Three months after PAE, IPSS score (t=14.66, 11.74, 29.02), QOL score (t=8.51, 8.19, 7.99), PVR (t=11.68, 12.71, 16.80) and prostate volume (t=14.75, 17.45, 27.42) decreased compared with those before operation in all 3 groups (all P<0.01), and Qmax (t=-11.72, -10.80, -7.74) also statistically increased (all P<0.01). Conclusion: PAE is effective for PH in short-term. After accumulating 20 cases of PAE operation experience, the operation time and X-ray exposure are significantly shortened, and the learning curve turn to the plateau stage.