GreenLight photovaporization of the prostate in high-medical-risk patients: an analysis of the Global GreenLight Group (GGG) database.
World J Urol
; 40(7): 1755-1762, 2022 Jul.
Article
en En
| MEDLINE
| ID: mdl-35347413
ABSTRACT
PURPOSE:
We sought to characterize the adjusted outcomes of GreenLight photoselective vaporization of the prostate (PVP) in high-medical-risk (HMR) patients using data from the largest international database.METHODS:
Data were obtained from the Global GreenLight Group (GGG) database which pools data of eight high-volume, experienced surgeons, from a total of seven international centers. Eligible study participants underwent GreenLight PVP using the XPS-180 W system between 2011 and 2019. HMR patients were defined as patients with ASA III or greater and were compared to non-HMR patients. Analyses were adjusted for patient age and prostate volume.RESULTS:
In the HMR group, patients on average were older and had smaller prostates than the non-HMR control group. Compared to non-HMR patients, transfusions occurred more frequently (2.6% vs. 0.14%, p < 0.01) and the odds of readmission were elevated [OR 2.0, (95% CI 1.4-2.8, p < 0.01)] among HMR patients. Twelve months postoperatively, HMR patients experience greater improvement in QoL than the control group [+ 0.54 (95% CI 0.07-1.0, p = 0.02)]. PVR also decreased 93.1 ml more in HMR than in non-HMR patients after 12 months (95% CI 33.6-152.6, p < 0.01).CONCLUSION:
We found that GreenLight PVP is safe and effective in improving functional outcomes in higher-risk patients with severe systemic disease compared to their lower-risk counterparts. Though absolute risks remain low, GreenLight PVP is associated with higher odds of transfusion and readmission in the high-risk cohort. The findings of our study reaffirm current guidelines that propose PVP as a viable treatment option for HMR patients.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Hiperplasia Prostática
/
Resección Transuretral de la Próstata
/
Terapia por Láser
Tipo de estudio:
Etiology_studies
/
Guideline
/
Observational_studies
/
Risk_factors_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
World J Urol
Año:
2022
Tipo del documento:
Article
País de afiliación:
Canadá