Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience?
Objective: To provide the first large single-operator case series of patients who undergo “en bloc” thulium laser enucleation of the prostate (ThuLEP) and to demonstrate an improvement in enucleation efficacy with experience. Methods: We prospectively evaluated a cohort of patients with symptomatic...
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Elsevier
2019-10-01
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| Series: | Asian Journal of Urology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388219300062 |
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| author | Giovanni Saredi Giacomo Maria Pirola Francesca Ambrosini Simone Barbieri Lorenzo Berti Andrea Pacchetti Domenico Iovino Giuseppe Ietto Letizia Libassi Giulio Carcano |
| author_facet | Giovanni Saredi Giacomo Maria Pirola Francesca Ambrosini Simone Barbieri Lorenzo Berti Andrea Pacchetti Domenico Iovino Giuseppe Ietto Letizia Libassi Giulio Carcano |
| author_sort | Giovanni Saredi |
| collection | DOAJ |
| description | Objective: To provide the first large single-operator case series of patients who undergo “en bloc” thulium laser enucleation of the prostate (ThuLEP) and to demonstrate an improvement in enucleation efficacy with experience. Methods: We prospectively evaluated a cohort of patients with symptomatic benign prostatic hyperplasia (BPH) who underwent “en bloc” ThuLEP between May 2015 and November 2017. Association between dependent variables (delivered energy and operating time) and independent variables (adenoma volume and experience) were estimated with regression analysis. The experience was calculated as the time interval between the date of the first operation of the series and the date of the operation being considered. Results: A total of 100 patients were registered for the study. Median operative time was 56.5 min (interquartile range [IQR]: 40–85 min). Median enucleation time was 17.4 min (IQR: 15–21.5 min). Median enucleation index (enucleation time per adenoma gram) was 0.3 min/g (0.2–0.3 min/g). The overall operative time is not influenced by experience, but we registered a significant trend towards a reduction in the total amount of energy delivered energy normalized per adenoma gram (p = 0.0148). Conclusion: We believe that further attention is needed for these new “en bloc” prostatic enucleation techniques, which can facilitate some surgical steps, leading to a widespread use of laser technology for BPH surgical treatment. Keywords: Benign prostatic hyperplasia, Endoscopic enucleation of the prostate, Laser surgery, Thulium laser enucleation of the prostate |
| format | Article |
| id | doaj-art-c52628f628bf49ae88ab4cf5446f3f39 |
| institution | OA Journals |
| issn | 2214-3882 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-c52628f628bf49ae88ab4cf5446f3f392025-08-20T02:00:38ZengElsevierAsian Journal of Urology2214-38822019-10-016433934510.1016/j.ajur.2019.01.005Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience?Giovanni Saredi0Giacomo Maria Pirola1Francesca Ambrosini2Simone Barbieri3Lorenzo Berti4Andrea Pacchetti5Domenico Iovino6Giuseppe Ietto7Letizia Libassi8Giulio Carcano9Department of Urology, Ospedale di Circolo e Fondazione Macchi, Varese, ItalyDepartment of Urology, Usl Toscana Sud Est, San Donato Hospital, Arezzo, Italy; Corresponding author.Department of Urology, Ospedale di Circolo e Fondazione Macchi, Varese, ItalyCentro Cardiologico Monzino, IRCCS, Milan, ItalyDepartment of Urology, Ospedale di Circolo e Fondazione Macchi, Varese, ItalyDepartment of Urology, University of Genova, Genova, ItalyDepartment of Surgery, University of Insubria, Varese, ItalyDepartment of Surgery, University of Insubria, Varese, ItalyDepartment of Surgery, University of Insubria, Varese, ItalyDepartment of Surgery, University of Insubria, Varese, ItalyObjective: To provide the first large single-operator case series of patients who undergo “en bloc” thulium laser enucleation of the prostate (ThuLEP) and to demonstrate an improvement in enucleation efficacy with experience. Methods: We prospectively evaluated a cohort of patients with symptomatic benign prostatic hyperplasia (BPH) who underwent “en bloc” ThuLEP between May 2015 and November 2017. Association between dependent variables (delivered energy and operating time) and independent variables (adenoma volume and experience) were estimated with regression analysis. The experience was calculated as the time interval between the date of the first operation of the series and the date of the operation being considered. Results: A total of 100 patients were registered for the study. Median operative time was 56.5 min (interquartile range [IQR]: 40–85 min). Median enucleation time was 17.4 min (IQR: 15–21.5 min). Median enucleation index (enucleation time per adenoma gram) was 0.3 min/g (0.2–0.3 min/g). The overall operative time is not influenced by experience, but we registered a significant trend towards a reduction in the total amount of energy delivered energy normalized per adenoma gram (p = 0.0148). Conclusion: We believe that further attention is needed for these new “en bloc” prostatic enucleation techniques, which can facilitate some surgical steps, leading to a widespread use of laser technology for BPH surgical treatment. Keywords: Benign prostatic hyperplasia, Endoscopic enucleation of the prostate, Laser surgery, Thulium laser enucleation of the prostatehttp://www.sciencedirect.com/science/article/pii/S2214388219300062 |
| spellingShingle | Giovanni Saredi Giacomo Maria Pirola Francesca Ambrosini Simone Barbieri Lorenzo Berti Andrea Pacchetti Domenico Iovino Giuseppe Ietto Letizia Libassi Giulio Carcano Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience? Asian Journal of Urology |
| title | Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience? |
| title_full | Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience? |
| title_fullStr | Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience? |
| title_full_unstemmed | Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience? |
| title_short | Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience? |
| title_sort | feasibility of en bloc thulium laser enucleation of the prostate in a large case series are results enhanced by experience |
| url | http://www.sciencedirect.com/science/article/pii/S2214388219300062 |
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