The effect of increased maximum power output on perioperative and early postoperative outcome in photoselective vaporization of the prostate
| Autor: | Nicole Ebinger Mundorff, Gernot Bonkat, Alexander Bachmann, Thomas C. Gasser, Heike Püschel, Georg Müller, Stephen Wyler, Malte Rieken |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
business.industry media_common.quotation_subject Urology Dermatology Perioperative medicine.disease Laser Urination law.invention medicine.anatomical_structure Lower urinary tract symptoms law Prostate Vaporization medicine Dysuria Surgery Photoselective vaporization medicine.symptom business media_common |
| Zdroj: | Lasers in Surgery and Medicine. 45:28-33 |
| ISSN: | 0196-8092 |
| Popis: | Background and Objective Preclinical studies suggest an increased vaporization rate and speed of the 532 nm 180-W XPS GreenLight laser (180-W) compared with the 120-W HPS GreenLight laser (120-W) and the 80-W PV GreenLight laser (80-W). To test the clinical relevance of this observation we analyzed intraoperative data and early postoperative results after photoselective vaporization of the prostate (PVP) with the 180-W, 120-W, and 80-W laser. Study Design/Materials and Methods A retrospective pair-to-pair comparison was performed including 80 consecutive patients who underwent PVP for the treatment of benign prostate enlargement with the 180-W, 120-W, and 80-W laser. The groups matched concerning age, prostate volume, PSA-value, and preoperative catheterization. Primary study outcome measurement was PSA-value reduction at 3 months; intraoperative data, perioperative complications, and early postoperative functional course were secondary study outcome measurements. Results Energy application per case (kJ), preoperative prostate volume (kJ/ml) operating time (kJ/minute), and lasing time (kJ/minute) was significantly higher with the 180-W laser. Prevalence of impaired visibility due to bleeding was comparable between the 180-W and the 120-W laser but significantly lower with 80-W. Duration of hospitalization was shorter with the 180-W laser compared to the former laser systems. During the postoperative course of 3 months voiding parameters and micturition symptoms significantly improved in all groups, the incidence of postoperative dysuria was comparable. Postoperative PSA-value reduction was significantly higher after treatment with the 180-W laser. Conclusions With the 180-W laser, higher energy application and higher speed of tissue vaporization leads to increased tissue vaporization compared to the former 120-W and 80-W laser systems. Clinical efficacy and perioperative safety are maintained with the higher powered laser. Lasers Surg. Med. 45: 28–33, 2013. © 2012 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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