Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.
Identifieur interne : 000121 ( PubMed/Corpus ); précédent : 000120; suivant : 000122Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.
Auteurs : Steffen Rausch ; Thomas Heider ; Jens Bedke ; Stephan Kruck ; Christian Schwentner ; Karsten Fischer ; Arnulf Stenzl ; Tilman K LbleSource :
- Urology [ 1527-9995 ] ; 2015.
English descriptors
- KwdEn :
- Age Factors, Aged, Aged, 80 and over, Aluminum (adverse effects), Aluminum (therapeutic use), Humans, Male, Middle Aged, Organ Size, Postoperative Complications (epidemiology), Postoperative Complications (etiology), Prospective Studies, Prostate (pathology), Prostatectomy (adverse effects), Prostatectomy (methods), Prostatic Hyperplasia (pathology), Prostatic Hyperplasia (surgery), Recovery of Function, Risk Factors, Thulium (adverse effects), Thulium (therapeutic use), Time Factors, Treatment Outcome, Yttrium (adverse effects), Yttrium (therapeutic use).
- MESH :
- chemical , adverse effects : Aluminum, Thulium, Yttrium.
- chemical , therapeutic use : Aluminum, Thulium, Yttrium.
- adverse effects : Prostatectomy.
- epidemiology : Postoperative Complications.
- etiology : Postoperative Complications.
- methods : Prostatectomy.
- pathology : Prostate, Prostatic Hyperplasia.
- surgery : Prostatic Hyperplasia.
- Age Factors, Aged, Aged, 80 and over, Humans, Male, Middle Aged, Organ Size, Prospective Studies, Recovery of Function, Risk Factors, Time Factors, Treatment Outcome.
Abstract
To evaluate complications and functional outcome and to identify patient-associated risk factors, we analyzed consecutive patients undergoing thulium:yttrium-aluminum-garnet laser enucleation of the prostate (ThuLEP) in our department.
DOI: 10.1016/j.urology.2014.10.002
PubMed: 25530383
Links to Exploration step
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Electronic address: steffen.rausch@med.uni-tuebingen.de.</nlm:affiliation></affiliation></author><author><name sortKey="Heider, Thomas" sort="Heider, Thomas" uniqKey="Heider T" first="Thomas" last="Heider">Thomas Heider</name><affiliation><nlm:affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Bedke, Jens" sort="Bedke, Jens" uniqKey="Bedke J" first="Jens" last="Bedke">Jens Bedke</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kruck, Stephan" sort="Kruck, Stephan" uniqKey="Kruck S" first="Stephan" last="Kruck">Stephan Kruck</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Schwentner, Christian" sort="Schwentner, Christian" uniqKey="Schwentner C" first="Christian" last="Schwentner">Christian Schwentner</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Fischer, Karsten" sort="Fischer, Karsten" uniqKey="Fischer K" first="Karsten" last="Fischer">Karsten Fischer</name><affiliation><nlm:affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Stenzl, Arnulf" sort="Stenzl, Arnulf" uniqKey="Stenzl A" first="Arnulf" last="Stenzl">Arnulf Stenzl</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="K Lble, Tilman" sort="K Lble, Tilman" uniqKey="K Lble T" first="Tilman" last="K Lble">Tilman K Lble</name><affiliation><nlm:affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="doi">10.1016/j.urology.2014.10.002</idno><idno type="RBID">pubmed:25530383</idno><idno type="pmid">25530383</idno><idno type="wicri:Area/PubMed/Corpus">000121</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000121</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.</title><author><name sortKey="Rausch, Steffen" sort="Rausch, Steffen" uniqKey="Rausch S" first="Steffen" last="Rausch">Steffen Rausch</name><affiliation><nlm:affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany; Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany. Electronic address: steffen.rausch@med.uni-tuebingen.de.</nlm:affiliation></affiliation></author><author><name sortKey="Heider, Thomas" sort="Heider, Thomas" uniqKey="Heider T" first="Thomas" last="Heider">Thomas Heider</name><affiliation><nlm:affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Bedke, Jens" sort="Bedke, Jens" uniqKey="Bedke J" first="Jens" last="Bedke">Jens Bedke</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kruck, Stephan" sort="Kruck, Stephan" uniqKey="Kruck S" first="Stephan" last="Kruck">Stephan Kruck</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Schwentner, Christian" sort="Schwentner, Christian" uniqKey="Schwentner C" first="Christian" last="Schwentner">Christian Schwentner</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Fischer, Karsten" sort="Fischer, Karsten" uniqKey="Fischer K" first="Karsten" last="Fischer">Karsten Fischer</name><affiliation><nlm:affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Stenzl, Arnulf" sort="Stenzl, Arnulf" uniqKey="Stenzl A" first="Arnulf" last="Stenzl">Arnulf Stenzl</name><affiliation><nlm:affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="K Lble, Tilman" sort="K Lble, Tilman" uniqKey="K Lble T" first="Tilman" last="K Lble">Tilman K Lble</name><affiliation><nlm:affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Urology</title><idno type="eISSN">1527-9995</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Aluminum (adverse effects)</term><term>Aluminum (therapeutic use)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Organ Size</term><term>Postoperative Complications (epidemiology)</term><term>Postoperative Complications (etiology)</term><term>Prospective Studies</term><term>Prostate (pathology)</term><term>Prostatectomy (adverse effects)</term><term>Prostatectomy (methods)</term><term>Prostatic Hyperplasia (pathology)</term><term>Prostatic Hyperplasia (surgery)</term><term>Recovery of Function</term><term>Risk Factors</term><term>Thulium (adverse effects)</term><term>Thulium (therapeutic use)</term><term>Time Factors</term><term>Treatment Outcome</term><term>Yttrium (adverse effects)</term><term>Yttrium (therapeutic use)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Aluminum</term><term>Thulium</term><term>Yttrium</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Aluminum</term><term>Thulium</term><term>Yttrium</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Prostatectomy</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Prostatectomy</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Prostate</term><term>Prostatic Hyperplasia</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Prostatic Hyperplasia</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Organ Size</term><term>Prospective Studies</term><term>Recovery of Function</term><term>Risk Factors</term><term>Time Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To evaluate complications and functional outcome and to identify patient-associated risk factors, we analyzed consecutive patients undergoing thulium:yttrium-aluminum-garnet laser enucleation of the prostate (ThuLEP) in our department.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">25530383</PMID><DateCreated><Year>2014</Year><Month>12</Month><Day>22</Day></DateCreated><DateCompleted><Year>2015</Year><Month>02</Month><Day>23</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1527-9995</ISSN><JournalIssue CitedMedium="Internet"><Volume>85</Volume><Issue>1</Issue><PubDate><Year>2015</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Urology</Title><ISOAbbreviation>Urology</ISOAbbreviation></Journal><ArticleTitle>Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.</ArticleTitle><Pagination><MedlinePgn>182-8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.urology.2014.10.002</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0090-4295(14)01097-8</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To evaluate complications and functional outcome and to identify patient-associated risk factors, we analyzed consecutive patients undergoing thulium:yttrium-aluminum-garnet laser enucleation of the prostate (ThuLEP) in our department.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A total of 234 patients were prospectively analyzed. Preoperative data, postoperative complications, and outcome at 6, 12, and 24 months were recorded. Individual risk factors for complications and treatment failure were assessed by univariate and multivariate analyses.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Mean age at surgery was 72.88 ± 7.83 years. Mean preoperative prostate size was 84.8 ± 34.9 mL. Thirty-day complication rate was 19.7%. Functional treatment failure occurred in 9.0% of all patients. Decline of mean International Prostate Symptom Score was -75%, quality of life index -76%, and postvoid residual -86% at 24 months. Maximum urine flow at 24 months was improved at +231%. In univariate analysis, age >80 years and prostate size <50 mL were significant predictors of complications, which was confirmed by multivariate analysis (P = .0277 and .0409, respectively). Age >80 years, prostate size <80 mL or <50 mL, and American Society of Anesthesiologists classification were significant predictors of functional treatment failure in univariate analysis. Prostate size <80 mL or <50 mL was significantly associated with treatment failure (P < .001) in multivariate analysis.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">ThuLEP is a safe and efficient surgical procedure, even in a patient cohort with high prostate volumes, age, and comorbidities. However, high patient age and small prostate size were significant determinants of adverse outcomes after surgery. To address the question of optimal therapy selection for patients with prostates smaller than 80 mL, further prospective randomized evaluation of ThuLEP and alternative surgical interventions is needed.</AbstractText><CopyrightInformation>Copyright © 2015 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rausch</LastName><ForeName>Steffen</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany; Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany. Electronic address: steffen.rausch@med.uni-tuebingen.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heider</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bedke</LastName><ForeName>Jens</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kruck</LastName><ForeName>Stephan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schwentner</LastName><ForeName>Christian</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fischer</LastName><ForeName>Karsten</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stenzl</LastName><ForeName>Arnulf</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kälble</LastName><ForeName>Tilman</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Urology, Klinikum Fulda, Fulda, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Urology</MedlineTA><NlmUniqueID>0366151</NlmUniqueID><ISSNLinking>0090-4295</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C503779">yttrium-aluminum-garnet</NameOfSubstance></Chemical><Chemical><RegistryNumber>58784XQC3Y</RegistryNumber><NameOfSubstance UI="D015019">Yttrium</NameOfSubstance></Chemical><Chemical><RegistryNumber>8RKC5ATI4P</RegistryNumber><NameOfSubstance UI="D013932">Thulium</NameOfSubstance></Chemical><Chemical><RegistryNumber>CPD4NFA903</RegistryNumber><NameOfSubstance UI="D000535">Aluminum</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000367">Age Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000369">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000535">Aluminum</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</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="D009929">Organ Size</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011183">Postoperative Complications</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000453">epidemiology</QualifierName><QualifierName MajorTopicYN="N" UI="Q000209">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011446">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011467">Prostate</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000473">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011468">Prostatectomy</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011470">Prostatic Hyperplasia</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000473">pathology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020127">Recovery of Function</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012307">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013932">Thulium</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013997">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016896">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D015019">Yttrium</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>8</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2014</Year><Month>9</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2014</Year><Month>10</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>12</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>12</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>2</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pii">S0090-4295(14)01097-8</ArticleId><ArticleId IdType="doi">10.1016/j.urology.2014.10.002</ArticleId><ArticleId IdType="pubmed">25530383</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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