[HoLEP learning curve: Toward a standardised formation and a team strategy]. / Apprentissage de l'HoLEP : vers une formation standardisée et une stratégie d'équipe.
Prog Urol
; 26(9): 492-9, 2016 Sep.
Article
em Fr
| MEDLINE
| ID: mdl-27614386
ABSTRACT
AIM:
Holmium laser enucleation of prostate (HoLEP) is renowned for the difficulty of its learning curve. Our aim was to evaluate the interest of a three-step tutorial in the HoLEP learning curve, in a university center.METHODS:
It is a retrospective, monocentric study of the 82 first procedures done consecutively by the same operator with a proctoring in early experience and after 40 procedures. For all patients were noted enucleation efficiency (g/min), morcellation efficiency (g/min), percentage of enucleated tissue (enucleated tissue/adenome weigth evaluated by ultrasonography. g/g), perioperative morbidity (Clavien), length of hospital stay, length of urinary drainage, functional outcomes at short and middle term (Qmax, post-void residual volume [PVR], QOL scores and IPSS at 3 and 6months).RESULTS:
Enucleation and morcellation efficiency were significantly higher after the second proctoring (0.87 vs 0.44g/min; P<0.0001 and 4.2 vs 3.37g/min, P=0.038, respectively) so as the prostatic volume (43.5 vs 68.1mL, P=0.0001). Percentage of enucleated tissue was higher in the second group, however, the difference was not significant (69.5% vs 80.4%, P=0.03). Per- and postoperative complications, hospital length of stay, urinary drainage length and functional results at 3 and 6months were not significantly different.CONCLUSION:
The learning curve did not interfere with functional results. The second proctoring was essential to us in order to grasp the technique. These data underlined the necessity of a pedagogic reflexion in order to built a standardized formation technique to the HoLEP. LEVEL OF EVIDENCE 4.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
/
Hiperplasia Prostática
/
Lasers de Estado Sólido
/
Curva de Aprendizado
Idioma:
Fr
Ano de publicação:
2016
Tipo de documento:
Article