Evaluation of the learning curve for transurethral plasmakinetic enucleation and resection of prostate using a mentor-based approach

AUTOR(ES)

Feng, Lang, Song, Jian, Zhang, Daoxin, Tian, Ye

FONTE

Int. braz j urol.

DATA DE PUBLICAÇÃO

2017-04

RESUMO

ABSTRACT Objective To analyze the mentor-based learning curve of one single surgeon with transurethral plasmakinetic enucleation and resection of prostate (PKERP) prospectively. Materials and Methods Ninety consecutive PKERP operations performed by one resident under the supervision of an experienced endourologist were studied. Operations were analyzed in cohorts of 10 cases to determine when a plateau was reached for the variables such as operation efficiency, enucleation efficiency and frequency of mentor advice (FMA). Patient demographic variables, perioperative data, complications and 12-month follow-up data were analyzed and compared with the results of a senior urologist. Results The mean operative efficiency and enucleation efficiency increased from a mean of 0.49±0.09g/min and 1.11±0.28g/min for the first 10 procedures to a mean of 0.63±0.08g/min and 1.62±0.36g/min for case numbers 31-40 (p=0.003 and p=0.002). The mean value of FMA decreased from a mean of 6.7±1.5 for the first 10 procedures to a mean of 2.8±1.2 for case numbers 31-40 (p<0.01). The senior urologist had a mean operative efficiency and enucleation efficiency equivalent to those of the senior resident after 40 cases. There was significant improvement in 3, 6 and 12 month’s parameter compared with preoperative values (p<0.001). Conclusions PKERP can be performed safely and efficiently even during the initial learning curve of the surgeon when closely mentored. Further well-designed trials with several surgeons are needed to confirm the results.

Documentos Relacionados

• A prospective randomized study comparing bipolar plasmakinetic transurethral resection of the prostate and monopolar transurethral resection of the prostate for the treatment of Benign Prostatic Hyperplasia: efficacy, sexual function, Quality of Life, and complications
• Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60gr: A retrospective study at a single academic tertiary care center
• Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate
• Prostate specific antigen levels following transurethral resection of the prostate
• Lower Nephron Nephrosis after Transurethral Resection of the Prostate