Safety and efficacy of GreenLight PVP in octogenarians: evaluation of the Global GreenLight Group database.

Autor: Deyirmendjian C; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada., Nguyen DD; Division of Urology, University of Toronto, Toronto, ON, Canada., Law KW; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada., Nguyen AV; Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Sadri I; Division of Urology, McGill University, Montreal, QC, Canada., Arezki A; Division of Urology, McGill University, Montreal, QC, Canada., Bouhadana D; Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada., Ibrahim A; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada., Bhojani N; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada., Elterman DS; Division of Urology, University Health Network, Toronto, ON, Canada., Chughtai B; Department of Urology, Weill Cornell Medical College, New York, NY, USA., Bruyère F; Department of Oncology and Urology, Centre Hospitalier Universitaire de Tours, Centre-Val de Loire, France., Cindolo L; Department of Urology, Hesperia Hospital, 'Cure Group', Modena, Italy., Ferrari G; Department of Urology, Hesperia Hospital, 'Cure Group', Modena, Italy., Vasquez-Lastra C; Department of Urology, ABC Medical Center, Mexico City, Mexico., Borelli-Bovo T; Borelli Urologia, Ribeirão Presto, Sao Paulo, Brazil., Becher EF; Centro de Urologia, CDU, Buenos Aires, Argentina., Cash H; Prouro, Urology Berlin, Berlin, Germany.; Department of Urology, University of Magdeburg, Magdeburg, Germany., Reimann M; Department of Urology, Charité - Universitaetsmedizin Berlin, Berlin, Germany., Rijo E; Department of Urology, Hospital Quiron Barcelona, Barcelona, Spain., Misrai V; Department of Urology, Clinique Pasteur, Toulouse, France., Zorn KC; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2023 Apr; Vol. 41 (4), pp. 1133-1140. Date of Electronic Publication: 2023 Feb 23.
DOI: 10.1007/s00345-023-04334-x
Abstrakt: Introduction: The present study analyzes the largest international GreenLight database, the Global GreenLight Group (GGG), to evaluate the functional and safety profile of GreenLight photoselective vaporization of the prostate (PVP) in octogenarians.
Methods: The GGG is a database comprised of patients that underwent GreenLight PVP from 2011 to 2019 performed by 8 experienced urologists at 7 international hospitals. Patients 80 years or older at the time of surgery were categorized as octogenarians. They were compared to a similar group of PVP patients below the age of 80.
Results: Among 3,648 patients, 586 men were above the age of 80. Compared to patients under the age of 80, octogenarians had larger prostates (76.0 vs 71.9 ml, p = 0.02) and a lower BMI (25.6 vs 26.7, p = 0.045). Operative time was not significantly longer in octogenarians. The improvement in functional outcomes between 80-year-old patients and control patients was not significantly different at one-year follow-up, with the exception of maximum urinary flow (Q max ) that favoured younger patients (10.3 vs 12.6 ml/s, p = 0.02). The odds of transfusion were greater for older patients [OR 8.2 (95% CI 3.6-18.9, p < 0.01)], but they were not at increased risk of hematuria. Octogenarians had higher readmission rates (23.0 vs 11.9%, p < 0.01).
Conclusions: GreenLight PVP is a safe option in well-selected octogenarians in a cohort of patients treated by surgeons experienced with the technology. The odds of transfusion were higher in patients over 80, but the absolute risk remains low. The 30-day hospital readmission rate was higher in octogenarians.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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