Enucleated Weight/Enucleation Time, Is It Appropriate for Estimating Enucleation Skills for Holmium Laser Enucleation of the Prostate? A Consideration of Energy Consumption

The World Journal of Men's Health

卷:36

Khae Hawn Kim¹  Tae Beom Kim¹  Han Jung¹  Kyung Jin Chung¹  Jin Kyu Oh¹  Kwang Taek Kim¹  Sang Jin Yoon¹ 

[1] Gachon University Gil Medical Center;

关键词: Lasers;    solid-state;    Learning curve;    Prostatic hyperplasia;   

DOI  :  10.5534/wjmh.17039

来源: DOAJ

【 摘 要 】

Purpose: To date, the parameters for evaluating enucleation efficiency have only considered enucleation time, althoughoperators simultaneously consume both time and energy during holmium laser enucleation of the prostate. This study wasundertaken to find a better way of assessing enucleation skills, considering both enucleation time and consumed energy.Materials and Methods: One hundred (n=100) consecutive patients who underwent holmium laser enucleation of the prostatefrom April 2012 to April 2014 by a single surgeon were enrolled. Ten groups of 10 consecutive cases were used to analyze theparameters of enucleation efficiency.Results: The mean enucleation time, consumed energy, and enucleated weight were 41.3±19.2 minutes, 66.2±36.0 kJ, and26.6±21.8 g, respectively. Concerning learning curves, like enucleation time-efficacy (=enucleated weight/enucleation time),enucleation energy-efficacy (=enucleated weight/consumed energy) also had an increasing tendency. Enucleation ratio efficacy(=enucleated weight/transitional zone volume/enucleation time) plateaued after 30 cases. However, enucleation time-energyefficacy(=enucleated weight/enucleation time/consumed energy) continued to increase after 30 cases and plateaued at 61 to 70cases. Furthermore, one-way analysis of variance showed that group means for enucleation time-energy-efficacy (F=3.560,p=0.001) were significantly different, but that those of enucleation ratio efficacy (F=1.931, p=0.057) were not.Conclusions: When both time and energy were considered, enucleation skills continued to improve even after 30 cases andplateaued at 61 to 70 cases. Therefore, we propose that enucleation time-energy-efficacy should be used as a more appropriateparameter than enucleation ratio efficacy for evaluating enucleation skills.

【 授权许可】

Unknown