Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience.
Identifieur interne : 000076 ( PubMed/Corpus ); précédent : 000075; suivant : 000077Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience.
Auteurs : Giovanni Saredi ; Giacomo Maria Pirola ; Andrea Pacchetti ; Jon Alexander Lovisolo ; Giacomo Borroni ; Federico Sembenini ; Alberto Mario MarconiSource :
- BMC urology [ 1471-2490 ] ; 2015.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Clinical Competence, Cohort Studies, Follow-Up Studies, Humans, Laser Therapy (methods), Learning Curve, Male, Middle Aged, Minimally Invasive Surgical Procedures (methods), Prospective Studies, Prostatic Hyperplasia (pathology), Prostatic Hyperplasia (surgery), Prostatic Neoplasms (pathology), Prostatic Neoplasms (surgery), Regression Analysis, Risk Assessment, Thulium, Transurethral Resection of Prostate (methods), Treatment Outcome.
- MESH :
- chemical : Thulium.
- methods : Laser Therapy, Minimally Invasive Surgical Procedures, Transurethral Resection of Prostate.
- pathology : Prostatic Hyperplasia, Prostatic Neoplasms.
- surgery : Prostatic Hyperplasia, Prostatic Neoplasms.
- Aged, Aged, 80 and over, Clinical Competence, Cohort Studies, Follow-Up Studies, Humans, Learning Curve, Male, Middle Aged, Prospective Studies, Regression Analysis, Risk Assessment, Treatment Outcome.
Abstract
The aim of this study was to determine the learning curve for thulium laser enucleation of the prostate (ThuLEP) for two surgeons with different levels of urological endoscopic experience.
DOI: 10.1186/s12894-015-0045-2
PubMed: 26055885
Links to Exploration step
pubmed:26055885Le document en format XML
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Albertomario.marconi@ospedale.varese.it.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMC urology</title><idno type="eISSN">1471-2490</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Clinical Competence</term><term>Cohort Studies</term><term>Follow-Up Studies</term><term>Humans</term><term>Laser Therapy (methods)</term><term>Learning Curve</term><term>Male</term><term>Middle Aged</term><term>Minimally Invasive Surgical Procedures (methods)</term><term>Prospective Studies</term><term>Prostatic Hyperplasia (pathology)</term><term>Prostatic Hyperplasia (surgery)</term><term>Prostatic Neoplasms (pathology)</term><term>Prostatic Neoplasms (surgery)</term><term>Regression Analysis</term><term>Risk Assessment</term><term>Thulium</term><term>Transurethral Resection of Prostate (methods)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Thulium</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Laser Therapy</term><term>Minimally Invasive Surgical Procedures</term><term>Transurethral Resection of Prostate</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Prostatic Hyperplasia</term><term>Prostatic Neoplasms</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Prostatic Hyperplasia</term><term>Prostatic Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Clinical Competence</term><term>Cohort Studies</term><term>Follow-Up Studies</term><term>Humans</term><term>Learning Curve</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Regression Analysis</term><term>Risk Assessment</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to determine the learning curve for thulium laser enucleation of the prostate (ThuLEP) for two surgeons with different levels of urological endoscopic experience.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">26055885</PMID><DateCreated><Year>2015</Year><Month>06</Month><Day>09</Day></DateCreated><DateCompleted><Year>2016</Year><Month>04</Month><Day>18</Day></DateCompleted><DateRevised><Year>2015</Year><Month>06</Month><Day>12</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2490</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><PubDate><Year>2015</Year></PubDate></JournalIssue><Title>BMC urology</Title><ISOAbbreviation>BMC Urol</ISOAbbreviation></Journal><ArticleTitle>Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience.</ArticleTitle><Pagination><MedlinePgn>49</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12894-015-0045-2</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The aim of this study was to determine the learning curve for thulium laser enucleation of the prostate (ThuLEP) for two surgeons with different levels of urological endoscopic experience.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">From June 2012 to August 2013, ThuLEP was performed on 100 patients in our institution. We present the results of a prospective evaluation during which we analyzed data related to the learning curves for two surgeons of different levels of experience.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The prostatic adenoma volumes ranged from 30 to 130 mL (average 61.2 mL). Surgeons A and B performed 48 and 52 operations, respectively. Six months after surgery, all patients were evaluated with the International Prostate Symptom Score questionnaire, uroflowmetry, and prostate-specific antigen test. Introduced in 2010, ThuLEP consists of blunt enucleation of the prostatic apex and lobes using the sheath of the resectoscope. This maneuver allows clearer visualization of the enucleation plane and precise identification of the prostatic capsule. These conditions permit total resection of the prostatic adenoma and coagulation of small penetrating vessels, thereby reducing the laser emission time. Most of the complications in this series were encountered during morcellation, which in some cases was performed under poor vision because of venous bleeding due to surgical perforation of the capsule during enucleation.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Based on this analysis, we concluded that it is feasible for laser-naive urologists with endoscopic experience to learn to perform ThuLEP without tutoring. Those statements still require further validation in larger multicentric study cohort by several surgeon. The main novelty during the learning process was the use of a simulator that faithfully reproduced all of the surgical steps in prostates of various shapes and volumes.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Saredi</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Urology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. giovannisaredi@yahoo.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pirola</LastName><ForeName>Giacomo Maria</ForeName><Initials>GM</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Modena e Reggio Emilia, viale Borri, 57, 21100, Varese, Modena, Italy. gmo.pirola@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pacchetti</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Urology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. a.pacchetti.90@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lovisolo</LastName><ForeName>Jon Alexander</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Urology, Ospedale di Circolo di Busto Arsizio, Saronno, Italy. jalovis@hotmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Borroni</LastName><ForeName>Giacomo</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Surgery, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. medici.urologia@ospedale.varese.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sembenini</LastName><ForeName>Federico</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Statistics, Bicocca University, Milan, Italy. sembeninifederico@alice.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marconi</LastName><ForeName>Alberto Mario</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Department of Urology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. Albertomario.marconi@ospedale.varese.it.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>06</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Urol</MedlineTA><NlmUniqueID>100968571</NlmUniqueID><ISSNLinking>1471-2490</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>8RKC5ATI4P</RegistryNumber><NameOfSubstance UI="D013932">Thulium</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Int J Surg. 2014;12(2):103-8</RefSource><PMID Version="1">24316286</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Eur Urol. 2010 Sep;58(3):384-97</RefSource><PMID Version="1">20825758</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BJU Int. 2002 Dec;90(9):863-9</RefSource><PMID Version="1">12460346</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Endourol. 2005 Jan-Feb;19(1):25-31</RefSource><PMID Version="1">15735378</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Eur Urol. 2008 Jan;53(1):160-6</RefSource><PMID Version="1">17869409</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>World J Urol. 2009 Aug;27(4):541-5</RefSource><PMID Version="1">19184038</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Endourol. 2014 Jan;28(1):65-72</RefSource><PMID Version="1">23980542</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BJU Int. 2015 Oct;116(4):665-74</RefSource><PMID Version="1">24588806</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>BJU Int. 2011 Apr;107(7):1030-43</RefSource><PMID Version="1">21438974</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Urology. 2012 Apr;79(4):869-74</RefSource><PMID Version="1">22342411</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Eur Urol. 2013 May;63(5):859-67</RefSource><PMID Version="1">23245687</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>World J Urol. 2013 Oct;31(5):1231-8</RefSource><PMID Version="1">22733237</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>World J Urol. 2010 Feb;28(1):45-51</RefSource><PMID Version="1">20063164</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000369">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D002983">Clinical Competence</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D015331">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005500">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D053685">Laser Therapy</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D059032">Learning Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D019060">Minimally Invasive Surgical Procedures</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011446">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011470">Prostatic Hyperplasia</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011471">Prostatic Neoplasms</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName><QualifierName MajorTopicYN="N" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012044">Regression Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D018570">Risk Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013932">Thulium</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020728">Transurethral Resection of Prostate</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016896">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC4459696</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>11</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>6</Month><Day>2</Day></PubMedPubDate><PubMedPubDate PubStatus="aheadofprint"><Year>2015</Year><Month>6</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>6</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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