Transurethral Photoselective Vaporization versus Transvesical Open Enucleation for Prostatic Adenomas &gt;80ml: 12-mo Results of a Randomized Prospective Study

Alivizatos, Gerasimos; Skolarikos, Andreas; Chalikopoulos, Dimitrios; Papachristou, C.; Sopilidis, Odysseas; Dellis, Athanasios; Kastriotis, Ioannis; Deliveliotis, Charalambos

doi:10.1016/j.eururo.2007.11.044

Cited by 108 publications

(53 citation statements)

References 21 publications

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“…This finding is consistent with other studies evaluating PVP complications in which severe hematuria requiring any sort of hospital admission or intervention typically occurred in fewer than 5% of patients, much less frequently than for transient, mild hematuria. 1,7,[12][13][14][15][16] The reported incidence of post-PVP hematuria varies widely. In recent studies it ranged from as high as 78.5% to less than 10%, depending on the definition of DH.…”

Section: Discussionmentioning

confidence: 96%

Risk Factors for Delayed Hematuria Following Photoselective Vaporization of the Prostate

et al. 2013

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Section: Discussionmentioning

confidence: 96%

Risk Factors for Delayed Hematuria Following Photoselective Vaporization of the Prostate

et al. 2013

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“…Alivizatos et al 39,40 comparan en un estudio prospectivo randomizado adenomectomía y FVP con láser 80W en 125 pacientes con próstatas de más de 80cc. Los datos han sido publicados con un tiempo de seguimiento de 12 y de 18 meses.…”

Section: Próstatas Grandesunclassified

Papel actual de la fotovaporización prostática con Láser Greenlight HPS: Aspectos técnicos y revisión de la literatura

et al. 2009

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L a RTUp se considera el tratamiento quirúrgico de elección para los síntomas del tracto urinario inferior secundarios a HBP. Intentando disminuir las complicaciones asociadas a este procedimiento, pero manteniendo sus resultados a largo plazo, se han desarrollado distintas modalidades de tratamiento con distintos sistemas de creación de energía, la mayoría de ellos sin mucho éxito. Es el caso de la ablación transuretral con agujas (TUNA), microondas transuretrales (TUMT), coagulación intersticial por láser, láser de neodimio…Todas estas técnicas han demostrado un aceptable perfil de seguridad y eficacia a corto y medio plazo, pero el elevado porcentaje de pacientes con disconfort postoperatorio, así como unos malos resultados a largo plazo, ha hecho que la mayoría hayan caído en desuso.Disponemos actualmente de una técnica míni-mamente invasiva cuyos resultados parecen prometedores: la fotovaporización prostática (FVP) con láser Greenlight HPS 120W. Los primeros pasos con esta técnica fueron dados por Malek en la Clínica Mayo en 1998 1 utilizando un láser de 60W (la mitad de potencia que los actuales). Desde entonces numerosos estudios 2-4 han aportado datos que demuestran que se trata de una técnica con una tasa de complicaciones muy baja y unos excelentes resultados postoperatorios. Al mismo tiempo que ResumenLa fotovaporización prostática (FVP) con láser Greenlight HPS 120W es una de las modalidades para el tratamiento quirúrgico de la hiperplasia benigna de la próstata (HBP) más atractivas en la actualidad. Las características físicas propias de este láser le dotan de un excelente perfil de seguridad y eficacia, convirtiéndola en la técnica ideal para pacientes de alto riesgo quirúrgico o con anticoagulación/antiagregación activa. Además, la incuestionable disminución del tiempo de sondaje y de hospitalización con respecto a la resección transuretral de la próstata (RTUp), implica un postoperatorio inmediato mucho más cómodo para los pacientes.Hemos realizado una búsqueda bibliográfica en Medline/Pubmed, presentando en esta revisión los resultados de los estudios más recientes, así como las actuales técnicas quirúrgicas. También hemos revisado las limitaciones y aspectos controvertidos que se atribuyen a esta técnica en función de lo publicado en la literatura.Palabras clave: Hiperplasia benigna de próstata. Fotovaporización prostática. Láser Greenlight. Triborato de litio. Photoselective vaporization of the prostate with Laser Greenlight HPS: current role, technical aspects and review of the literature AbstractPhotoselective vaporization of the prostate with 120W HPS Greenlight laser is one of the most attractive modalities of surgical treatment for benign prostatic hyperplasia at present. The specific physical characteristics of this laser provides an excellent safety and effectiveness profile, making it the ideal technique for high-risk patients or patients ongoing oral anticoagulation. Moreover, the undeniable reduction of urethral catheterization time and hospital stay compared to transurethral resect...

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“…Open surgeries such as Trans-Vesical or Retropubic Adenomectomies are indicated in case of large adenoma and/or complex BPH but these techniques often show massive intraoperative blood loss and have the risk of blunt dissection particularly in the area around the apex and the urinary sphincter. [2][3][4][5] For this reason, new techniques have been developed to combine the benefits of open simple prostatectomy with potential advantages of minimally invasive technique such as laparoscopic and robotic approaches. Robotassisted laparoscopic simple prostatectomy (RASP) represents a new treatment alternative, in expert hands, for these complex cases.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted simple prostatectomy with temporary internal iliac arteries clamping: our preliminary results

Falavolti¹,

Petitti²,

Buscarini³

2017

MIS

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Aim: This study proposed the robot-assisted laparoscopic simple prostatectomy (RASP) as safe and reliable surgical option for the treatment of men with prostate size > 80 mL. It was aimed to evaluate preoperative and postoperative results in RASP using a surgical variation to the standard technique: the temporary bilateral internal iliac arteries clamping. Methods: This study analyzed 18 patients underwent RASP with temporary clamping of bilateral internal iliac arteries. Procedures were performed by two surgeons in two different hospitals using the same surgical technique. Preoperative and postoperative data were collected and statistically analyzed. Results: The temporary clamping duration was less than 12 min during each adenoma's enucleation. Despite the vascular control, the median operating time was similar to RASP performed without iliac clamping. The results showed minimal blood loss, a median catheter duration of 5 days, a median duration of postoperative continuous catheter irrigation of 41 h, and short hospitalization (3.2 days). A significant corellation was observed between the estimated blood loss and the duration of irrigation. Conclusion: RASP performed with bilateral vascular control, combined with the known benefits of minimally invasive surgery resulted in bleeding reduction. The minimal blood loss further reduces catheter duration, decreases continuous catheter irrigation and patient's hospitalization duration. Key words:Benign prostatic hyperplasia, clamping, prostatectomy, robotic ABSTRACTArticle history:

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Transurethral Photoselective Vaporization versus Transvesical Open Enucleation for Prostatic Adenomas >80ml: 12-mo Results of a Randomized Prospective Study

Cited by 108 publications

References 21 publications

Risk Factors for Delayed Hematuria Following Photoselective Vaporization of the Prostate

Risk Factors for Delayed Hematuria Following Photoselective Vaporization of the Prostate

Papel actual de la fotovaporización prostática con Láser Greenlight HPS: Aspectos técnicos y revisión de la literatura

Robot-assisted simple prostatectomy with temporary internal iliac arteries clamping: our preliminary results

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