Holmium Laser Enucleation of the Prostate: Efficiency Gained by Experience and Operative Technique

被引:47
|
作者
Dusing, Michael W. [3 ]
Krambeck, Amy E. [2 ]
Terry, Colin [4 ]
Matlaga, Brian R. [6 ]
Miller, Nicole L. [7 ]
Humphreys, Mitchell R. [5 ]
Gnessin, Ehud [1 ]
Lingeman, James E. [1 ]
机构
[1] Methodist Hosp, Inst Kidney Stone Dis, Indianapolis, IN 46202 USA
[2] Mayo Clin, Rochester, MN USA
[3] Indiana Univ, Sch Med, Indianapolis, IN USA
[4] Methodist Res Inst, Indianapolis, IN USA
[5] Mayo Clin, Scottsdale, AZ USA
[6] Johns Hopkins Univ, Sch Med, Baltimore, MD USA
[7] Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA
来源
JOURNAL OF UROLOGY | 2010年 / 184卷 / 02期
关键词
prostatic; prostatic hyperplasia; lasers; solid-state; prostatectomy; transurethral resection of prostate; RANDOMIZED PROSPECTIVE TRIAL; TRANSURETHRAL RESECTION; FOLLOW-UP; CLINICAL-TRIAL; HYPERPLASIA; GRAMS; INSTITUTIONS; LARGER; HOLEP; SIZE;
D O I
10.1016/j.juro.2010.03.130
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Holmium laser enucleation of the prostate is highly effective for symptomatic benign prostatic hyperplasia. Despite its steep learning curve the procedure is an efficient treatment, especially for large prostate glands. We determined the change in enucleation efficiency with time with increased operative experience and improved technique. Materials and Methods: We reviewed the records of all 949 consecutive men who underwent holmium laser enucleation of the prostate between 1999 and 2007. Patients were excluded from analysis when enucleated gm or time was not recorded and enucleated tissue was less than 5 gm. Efficiency was measured in gm enucleated prostate tissue per minute. Descriptive statistics on laser time, gland weight and efficiency were evaluated in an 8-year period. Results: A total of 91 patients met study exclusion criteria, leaving 858 available for evaluation. Mean enucleation time was 94 minutes (range 12 to 485). Mean prostate specimen weight was 77 gm (range 5 to 376). Mean efficiency or enucleation rate was 0.55 vs 1.32 gm per minute in the first 4 vs the last 5 years. Further efficiency improvements were noted in the last 5 years with a mean of 1.57 gm per minute enucleated in the last 2 years. Conclusions: As experience with holmium laser enucleation of the prostate grows, advances in operative technique have been made. Prostatic enucleation efficiency continues to improve, further strengthening the role of holmium laser enucleation of the prostate for benign prostatic hyperplasia of small and large prostate glands.
引用
收藏
页码:635 / 640
页数:6
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