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01.12.2024 | Original Article

Evaluation of the learning curve for Thulium laser enucleation of the prostate in a contemporary cohort

verfasst von: D. Perri, A. Pacchetti, E. Morini, U. Besana, F. Mazzoleni, E. Verzotti, M. Maltagliati, J. Romero-Otero, A. L. Pastore, P. Broggini, B. Rocco, A. S. Gozen, P. Kallidonis, G. Bozzini

Erschienen in: World Journal of Urology | Ausgabe 1/2024

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Abstract

Purpose

To assess the learning curve of Thulium laser enucleation of the prostate (ThuLEP) of a single surgeon.

Methods

Hundred patients suffering from benign prostatic hyperplasia were treated by the same surgeon. In all cases, a well-trained urologist was present in the operating room. Patients urinary function was assessed preoperatively using the International Prostate Symptoms Score (IPSS), maximum flow rate and Post-Void Residual volume. Preoperative prostate volume was recorded. Enucleation and morcellation efficiency and complication rate were evaluated. Patients were divided into 5 cohorts of 20 consecutive cases to assess changes in outcomes through time.

Results

Mean age of patients was 73.1 years (SD 17.5) and mean prostate volume was 89.7 ml (SD 55.1). Overall, mean enucleation and morcellation efficiency were 1.7 (SD 2.9) and 5.1 (SD 2.7) g/min. A statistically significant increase in enucleation efficiency was observed when comparing cohort 1 vs 2 (0.9 vs 1.3 g/min, p = 0.03) and cohort 2 vs 3 (1.3 vs 1.7 g/min, p = 0.02). A statistically significant increase in morcellation efficiency was observed when comparing cohort 1 vs 2 (2.8 vs 3.7 g/min, p = 0.02) and cohort 2 vs 3 (3.7 vs 4.9 g/min, p = 0.03). In both cases, no significant differences were observed when comparing the following cohorts. Complication rate showed no significant differences throughout the caseload.

Conclusions

In our single-surgeon experience, we observed a learning curve of nearly 60 cases for the ThuLEP procedure in presence of a well-trained surgeon. Complication rate was low from the beginning of surgical experience.

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Titel: Evaluation of the learning curve for Thulium laser enucleation of the prostate in a contemporary cohort
verfasst von: D. Perri
A. Pacchetti
E. Morini
U. Besana
F. Mazzoleni
E. Verzotti
M. Maltagliati
J. Romero-Otero
A. L. Pastore
P. Broggini
B. Rocco
A. S. Gozen
P. Kallidonis
G. Bozzini
Publikationsdatum: 01.12.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 1/2024
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04958-7

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Evaluation of the learning curve for Thulium laser enucleation of the prostate in a contemporary cohort