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Ahyai, SA; Chun, FK; Lehrich, K; Dahlem, R; Zacharias, MS; Fisch, MM; Kuntz, RM.
Transurethral holmium laser enucleation versus transurethral resection of the prostate and simple open prostatectomy--which procedure is faster?
J Urol. 2012; 187(5):1608-13 Doi: 10.1016/j.juro.2011.12.107
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Führende Autor*innen der Med Uni Graz
Ahyai Sascha
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Abstract:
PURPOSE: The longer operative time of holmium laser enucleation of the prostate compared to transurethral resection of the prostate or simple open prostatectomy reported in the literature might have been biased by the unavailability of a soft tissue morcellator, limited surgical experience with holmium laser prostate enucleation or the fact that significantly more tissue was removed by enucleation than by resection. We objectively compared the resection speed of contemporary holmium laser enucleation vs transurethral resection of the prostate and of holmium laser enucleation vs simple open prostatectomy. MATERIALS AND METHODS: The study cohort consisted of 100 cases of transurethral prostate resection and 60 of simple open prostatectomy from our previous randomized, controlled trials. These cases were subjected to matched pair analysis with greater than 1,000 from our prospective contemporary database on holmium laser prostate enucleation. Exact matches were made for the same amount of resected tissue. In all contemporary holmium laser enucleation cases a mechanical soft tissue morcellator was used. We calculated and compared the specific resection speed in gm per minute and operative time for the same amount of resected tissue. RESULTS: In groups 1 and 2 we matched 99 exact laser enucleation-transurethral resection pairs and 53 exact laser enucleation-simple open prostatectomy pairs, respectively. Resection speed and operative time for laser enucleation were statistically significantly faster than for resection (0.61 vs 0.51 gm per minute and 62 vs 73 minutes, p <0.01) and similar to those of simple open prostatectomy (0.92 vs 1.0 gm per minute and 101 vs 90 minutes, respectively, p ≥0.21). CONCLUSIONS: Resection speed seems to be an objective criterion for comparing the efficacy of prostatic tissue removal. Based on resection speed holmium laser enucleation of the prostate is faster than transurethral resection of the prostate and similar to simple open prostatectomy.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Aged, 80 and over - administration & dosage
Humans - administration & dosage
Laser Therapy - administration & dosage
Lasers, Solid-State - therapeutic use
Male - administration & dosage
Matched-Pair Analysis - administration & dosage
Middle Aged - administration & dosage
Organ Size - administration & dosage
Prostate - pathology
Prostatectomy - administration & dosage
Prostatic Neoplasms - surgery
Time Factors - administration & dosage
Transurethral Resection of Prostate - administration & dosage

Find related publications in this database (Keywords)
prostate
prostatectomy
transurethral resection of prostate
laser therapy
prostatic hyperplasia
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