[Outcome of Photoselective Vaporizaion of the Prostate with 180 W Greenlight XPS™ System for Treatment of Large Prostatic Hyperplasia of at Least 100 Ml].

We report the outcome of photoselective vaporizaion of the prostate (PVP) with the 180W GreenLight XPS™ system (180 W-XPS) for large benign prostatic hyperplasia (BPH) with a prostate volume of ≥100 ml, in comparison with that with the 120 W GreenLight HPS™ system (120 W-HPS). We studied the outcomes of 86 patients who underwent PVP with 180 W-XPS for BPH with a prostate volume of ≥100 ml between February 2019 and October 2021, in comparison with those of 86 patients who underwent PVP with 120 W-HPS. 180 W-XPS significantly improved postoperative international prostate specific score, quality of life score, overactive bladder symptom score, Qmax, and residual urine volume. The operative time was significantly shorter in 180 W-XPS {100.5 min (150-175)}, than in 120 W-HPS {117.5 min (18-189)}, p＜ 0.05), the laser irradiation time was significantly shorter in 180 W-XPS {63.0 min (35-83)}, than in 120 WHPS : {79. 0 min (24-102)} (p ＜0. 05), and the laser fluence was significantly higher in 180 W-XPS {633647J (291991-805011)}, than in 120 W-HPS {396832J (40000-481842)} (p＜0. 05). At 3 and 12 months postoperatively, the prostate volume reduction rates were 59.8 and 66.7%, respectively, for the 180 W-XPS patients which were rates significantly higher than those for the 120 W-HPS patients, 49.5 and 45.0%, respectively. The PSA reduction rates were 58.1 and 53.2％, respectively, which were significantly higher rates than those for the 120 W-HPS patients, 41.3 and 25.7％, respectively. The 180 W-XPS system was considered to be a more effective and efficient treatment than the 120 W-HPS.

[Initial Experience with 180W-XPS Photoselective Vaporization of the Prostate (PVP) for Benign Prostatic Hyperplasia].

We analyzed the perioperative parameters, postoperative urinary status, and complications of 200 patients who underwent photoselective vaporization of the prostate (PVP) with the 180W-X-ray photoelectron spectroscopy (XPS) for benign prostatic hyperplasia at our hospital. In addition, we compared perioperative parameters and complications, as well as the rate of decrease in prostate-specific antigen (PSA) and prostate volume at 3 and 12 months after surgery, with those of the last 200 patients who underwent PVP with the 120W-high-performance system (HPS). The results showed significant differences between methods in operative time (XPS: 67.9±29.0 minutes, HPS: 95.2±32.1 minutes, p＜0.05), laser exposure time (XPS: 41.4±17.8 minutes, HPS: 60.1±19.7 minutes, p＜0.05), and laser dose (XPS: 385,937±180,872, HPS: 300,316±105,528, p＜0.05). In addition, there were significant differences in the rates of decrease in PSA and prostate volume in the 180W-XPS group compared with the 120W-HPS group. The transpiration efficiency of the 180W-XPS was higher than that of the 120W-HPS.

[Presurgical Treatment with Axitinib and Pembrolizumab Reduced Operation Risk by Downsizing the Vena Cava Tumor Thrombus in Clear Cell Renal Cell Carcinoma : A Case Report].

A woman in her seventies complained of chest pain during exertion and visited a local hospital. Computed tomographic scan showed right renal cell carcinoma with inferior vena cava (IVC) tumor thrombus extending above the diaphragm, and the patient was referred to our hospital. She was diagnosed with right renal cell carcinoma cT3cN0M0, with level IV IVC thrombus by Mayo classification. Axitinib and pembrolizumab were administered against intractable advanced renal cell carcinoma. The dose of axitinib was reduced due to grade 3 liver dysfunction. Right nephrectomy together with IVC thrombectomy was performed because the primary lesion had shrunk, and the level of IVC thrombus had become level III. The pathological results were clear cell carcinoma, pT3c, G3, Fuhrman grade3, INFA, v1, and ly0. Axitinib and pembrolizumab might be a presurgical option against an intractable renal cell carcinoma with an IVC thrombus.