單一醫學中心經驗：銩雷射攝護腺摘除手術學習曲線的回溯性評估
蔡佳龍1、黃景榆1、林嘉祥1, 2
1高雄義大醫院 泌尿外科；2高雄義守大學 學士後醫學系國際專班
Retrospective evaluation of the learning curve of the thulium laser enucleation of the prostate: a single center experience
Chia-Lung Tsai1, Ching-Yu Huang1, Victor C. Lin1,2
1Department of Urology, E-Da Hospital, Kaohsiung, Taiwan
2School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
Purpose:
The aim of this article is to describe the learning curve of ThuLEP (Thulium Laser Enucleation of Prostate) that permits a complete anatomical endoscopic enucleation of prostatic adenoma independently to prostate size.
Materials and Methods:
66 patients were enrolled between January 2013 and December 2014, and treated for BPH with ThuLEP. 24 patients were excluded due to malignancy, infection, bladder stone, blood clot tamponade and incomplete data. The following data of each patient was collected: prostate volume, International Prostate Symptoms Score (I-PSS), PSA value, total prostate volume, resected prostate weight, laser time. ThuLEP was performed by a single surgeon. The data was reviewed retrospectively.
Result:
Mean age at surgery was 68.9+/-9.2 years. Mean preoperative size of prostate was 79.8+/-26.8 ml Mean IPSS was 22.1+/-4.3. Mean resected prostate weight was 28.2+/-17.2 gm. Mean operation time was 113.8+/-34.5 minutes. Mean length of hospital day was 4.5+/-0.8 days. In the study, enucleation efficiency including the ratio of prostate weight to laser time and the ratio of resected prostate weight to total prostate volume was gradually improved by practice. However, the P-value of the enucleation efficiency was not significant.
Conclusion:
We shared our experience for the ThuLEP operation. ThuLEP has a steep learning curve. Based on the available data, the approach is safe and effective. Further, large-scale prospective studies are needed to prove long-term durability.