To assess the learning curve of Thulium laser enucleation of the prostate (ThuLEP) of a single surgeon.
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.
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.
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.
World journal of urology. 2024 Apr 20*** epublish ***
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
Division of Urology, Sant'Anna Hospital, Via Ravona 20, 22042, San Fermo della Battaglia, Italy. ., Division of Urology, Sant'Anna Hospital, Via Ravona 20, 22042, San Fermo della Battaglia, Italy., Department of Urology, Hospital Universitario, 12 De Octubre, Madrid, Spain., Department of Urology, Sapienza University, Rome, Italy., Sant'Anna Clinic, Lugano, Swiss, Switzerland., Department of Urology, ASST Santi Paolo e Carlo, Milan, Italy., Department of Urology, SLK-Kliniken Heilbronn, Heilbronn, Germany., Department of Urology, University Hospital of Patras, Patras, Greece.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38643250