Safety and effectiveness of high-power thulium laser enucleation of the prostate in patients with glands larger than 80 mL
執筆/
尹書田醫療財團法人書田泌尿科眼科診所主任 黃榮堯 Jung-Yao Huang
Safety and effectiveness of high-power thulium laser enucleation of the prostate in patients with glands larger than 80 mL
Ching-Hsin Chang, Tzu-Ping Lin and Jung-Yao Huang*
Abstract
Background: The efficacy of thulium laser prostate enucleation (ThuLEP) for large prostates is unclear. This study aimed to explore the expanded utility of 150–200-W ThuLEP by studying patients with a large prostate (> 80 mL).
Methods: We retrospectively reviewed records of 125 patients with large prostate glands (> 80 mL) who underwent ThuLEP performed by a single surgeon from June 2012 to June 2016. The ThuLEP data from our previous pilot study were used as the control. Operative variables, patient profiles, preoperative and postoperative urine flow rates, prostate volume, and the international prostate symptom score (IPSS) were recorded and analyzed using Student’s t-test, the z-test, and logistic regression analysis.
Results: Of 366 patients who underwent ThuLEP, 125 (34.15%) were enrolled. The ages and estimated prostate volumes were compared with those of the control. Overall, 39.2% underwent Foley placement and 4% received an anticoagulant agent preoperatively. Maximum urinary flow rates before and 3 and 12months postoperatively were 9. 93, 23.20, and 19.00 mL/s, respectively, which were generally equal to those of the control groups (P = 0.68, 0.18, 0.98, respectively). Preoperative and postoperative IPSSs were 27.09 and 7.35, respectively. The postoperative prostatespecific antigen was reduced by 85.59% in comparison to the preoperative level. The estimated prostate size was reduced by 74.17% postoperatively. The modified Clavien-Dindo classification system was used to identify the overall rate of complications, which was approximately 22.4%. The mortality rate was 0.8%.
Conclusions: High-power ThuLEP is safe and effective for patients with large prostate glands (> 80 mL). Prostate enucleation using a high-power thulium laser is feasible for patients who exhibit contraindications for surgery.
Keywords: Thulium laser, Enucleation, Large, Prostate, Bladder outlet obstruction, Open prostatectomy
Ching-Hsin Chang and Tzu-Ping Lin contributed equally to this work.
Shutien Uro Clinic, Taipei, Taiwan
Article in BMC Urology.December 2019
ThuLEP with Cyber TM - One Piece Technique (Dr. Jung-Yao Huang)
ThuLEP with Cyber TM - Two Piece Technique (Dr. Jung-Yao Huang)
BPH THuLEP ShuTien Jung Yao Huang - Thulium Laser - Cyber TM
銩雷射攝護腺全剝離手術（The LEP in ONE piece）
銩雷射攝護腺剝離手術
綠光雷射攝護腺剝除手術-1
綠光雷射攝護腺剝除手術-2
期刊原文
-
-