Complications Associated With Photoselective Vaporization of the Prostate: Categorization by a Panel of GreenLight Users According to Clavien Score and Report of a Single-center Experience
| Autor: | Benoit Peyronnet, Benjamin Pradere, Nicolas Brichart, Thomas Bodin, Philippe Bertrand, Franck Bruyère, A. Atassi, R. Benmeziani, T. Bodin, M. Breque, N. Brichart, J. Bron, F. Bruyere, P. Cloche, L. Corbel, L. Cormier, G. Cuvelier, G. Delporte, M. Fennouri, K. Ferhi, G. Fournier, G. Gabbay, X. Hurtes, B. Laplace, S. Le Gal, A. Lecouteux, G. Lesur, M. Lokmane, R. Mathieu, P. Metois, N. Miaadi, V. Misrai, J.L. Moreau, P. Mouly, C. Muyshondt, L. Obringer, M.A. Perrouin-Verbe, B. Peyronnet, B. Pradere, Y. Prezelin, P. Rigaud, A. Salin, N. Tabchouri, C. Tanchoux, P. Theveniaud, M. Thoulouzan, C. Thuillier, G. Verhoest |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Urology Fleiss' kappa Single Center Cohort Studies Postoperative Complications Risk Factors Prostate Surveys and Questionnaires medicine Humans Aged Aged 80 and over Prostatectomy business.industry Reproducibility of Results Middle Aged Surgery Treatment Outcome medicine.anatomical_structure Multivariate Analysis Cohort Prostate surgery Laser Therapy Volatilization Complication business Cohort study |
| Zdroj: | Urology. 84:657-664 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2014.05.028 |
| Popis: | Objective To devise and validate a system to categorize GreenLight photoselective vaporization of prostate (PVP) complications according to Clavien score (CS), to report complications of PVP using this categorization, and to determine risk factors. Materials and Methods A survey questionnaire was distributed to all participants of the second meeting of the Group of GreenLight Users. They were asked to grade PVP complications according to CS. We calculated the mode CS for each complication from the survey data to propose a categorization system for complications of PVP. Complications encountered in a large single-center cohort of 370 patients were reported according to this system. We assessed the reproducibility of CS by estimating inter-rater agreement by the Fleiss kappa. We performed univariate and multivariate analyses to determine risk factors for complications. Results Of the 67 meeting participants, 42 (62.7%) completed the survey. Overall agreement between urologists was fair (Fleiss kappa = 0.356). Among the 370 patients, 21 (5.7%) had intraoperative complications, 147 (39.7%) had postoperative complications, and 70 (18.9%) had long-term complications. Among the postoperative complications, 125 patients (33.8%) were classified as Clavien grade I, 58 (15.7%) as Clavien grade II, 4 (1.1%) as Clavien grade IIIb, 5 (1.3%) as Clavien grade IVa, 1 (0.3%) as Clavien grade IVb, and 1 (0.3%) as Clavien grade V. In multivariate analysis, the only predictor of overall complications was a polymicrobial preoperative urine culture. Conclusion The grading of PVP complications by CS is fairly reproducible. We are the first to propose a system for the categorization of PVP complications. PVP complications are frequent but most often minor. |
| Databáze: | OpenAIRE |
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