Day-case holmium laser enucleation and mechanical morcellation of the prostate [Ambulante Holmiumlasere-nukleation und mechanische Morcellierung der Prostata]

被引:0
作者
Abrolat R. [1 ]
Langer K. [1 ]
Roos N. [1 ]
机构
[1] Urologisches Zentrum Neustadt, 67434 Neustadt/Weinstr
来源
Der Urologe | 2009年 / 48卷 / 12期
关键词
BPH; Day-case; HoLEP; Laser; Morcellation;
D O I
10.1007/s00120-009-2099-9
中图分类号
学科分类号
摘要
Background: Holmium laser enucleation of the prostate (HoLEP) is increasingly being used as an alternative to transurethral resection of the prostate (TURP) and transurethral electrovaporisation of the prostate (TVP), the"gold standard" procedures for treating symptomatic benign prostatic hyperplasia. Mechanical tissue morcellation was introduced in 1998, and its efficiency could be improved. We investigated the efficiency and complication rate of a morcellator in a day-case setting. Methods: From 2004 to 2008, 137 men were treated with an 80W holmium:YAG laser and subsequent tissue morcellation. Results: The average patient age was 68.0±7.1 (51-86) years. Morcellation time was 8.6±6.8 (1-35) min. The weight of the resected tissue was 36.6±30.0 (2-175) g. The total time for the procedure was 69.6±28.7 (29-150) min, and the efficiency of morcellation was 5.0±2.6 (0.2-11.5) g/min. The complication rate due to morcellation was 4.3%. Conclusion: HoLEP with mechanical morcellation is safe even in a day-case setting. The total procedure time approximates that for TURP, so a longer theatre time loses significance as an argument against the method. Complications are rare and not severe. Further technical improvement is desirable. © 2009 Springer Medizin Verlag.
引用
收藏
页码:1490 / 1494
页数:4
相关论文
共 30 条
  • [1] Ahyai S.A., Lehrich K., Kuntz R.M., Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial, Eur Urol, 52, pp. 1456-1463, (2007)
  • [2] Elzayat E.A., Elhilali M.M., Holmium laser enucleation of the prostate (HoLEP): The endourologic alternative to open prostatectomy, Eur Urol, 49, pp. 87-91, (2006)
  • [3] Elzayat E.A., Mostafa M.E., Holmium laser enucleation of the prostate (HoLEP): Long-term results, reoperation rate and possible impact of the learning curve, Eur Urol, 52, pp. 1465-1471, (2007)
  • [4] Fraundorfer M.R., Gilling P.J., Holmium: YAG laser enucleation of the prostate combined with mechanical morcellation: Preliminary results, Eur Urol, 33, pp. 69-72, (1998)
  • [5] Gilling P.J., Kennett K., Das A.K., Et al., Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: An update on the early clinical experience, J Endourol, 12, pp. 457-459, (1998)
  • [6] Gupta N., Sivaramakrishna, Kumar R., Et al., Comparison of standard transurethral resection, transurethral vapour resection and holmium laser enucleation of the prostate for managing benign prostatic hyperplasia of >40 g, BJU Int, 97, pp. 85-89, (2006)
  • [7] Hettiarachchi J.A., Samadi A.A., Konno S., Das A.K., Holmium laser enucleation for large (greater than 100 mL) prostate glands, Int J Urol, 9, 5, pp. 233-236, (2002)
  • [8] Hochreiter W.W., Thalmann G.N., Burkhard F.C., Studer U.E., Holmium laser enucleation of the prostate combined with electrocautery resection: The mushroom technique, J Urol, 168, pp. 1470-1474, (2002)
  • [9] Hurle R., Vavassori I., Piccinelli A., Et al., Holmium laser enucleation of the prostate combined with mechanical morcellation in 155 patients with benign prostatic hyperplasia, Urology, 60, pp. 449-453, (2002)
  • [10] Kim S.C., Matlaga B.R., Kuo R.L., Et al., Holmium laser enucleation of the prostate: A comparison of efficiency measures at two institutions, J Endourol, 19, 5, pp. 555-558, (2005)