PURPOSE: To appraise the evaluation methods for learning curve and to analyze the non-mentor-aided learning curve and early complications following the holmium laser enucleation of the prostate. MATERIALS AND METHODS: One-hundred and forty (n=140) consecutive patients who underwent HoLEP from July 2008 to July 2010 by a single surgeon (SJO) were enrolled. Perioperative clinical variables, including enucleation time, morcellation time, enucleation ratio (enucleation weight/transitional zone volume), enucleation efficacy (enucleated weight/enucleation time), enucleation ratio efficacy (enucleation ratio/enucleation time), and early complication rate were analyzed. RESULTS: Mean prostate volume was 62.7 mL (range 21-162) and preoperative International Prostate Symptom Score (IPSS) was 19.0 (4-35). Mean enucleation time and morcellation time were 49.9 ± 23.8 (S.D.) min and 11.0 ± 9.7 min, respectively. Median duration of postoperative indwelling catheter was 1 (1-7) day and median hospital stay was 1 (1-6) day. There were a total of 31 surgery-related complications in 27 patients (19.3%), and all were manageable. There was an increasing trend of enucleation efficacy in the first 50 cases. However, enucleation efficacy was linearly correlated with the prostate size (correlation coefficients, R=0.701, p<0.001). But, enucleation ratio efficacy could eliminate the confounding effect of the prostate size (R=-0.101, p=0.233). The plateau of enucleation ratio efficacy was reached around the twenty-fifth case. CONCLUSIONS: Our results demonstrated that the operative learning curve plateau is reached after about 25 cases. We propose that a more appropriate parameter for estimating the operative learning curve is enucleation ratio efficacy, rather than enucleation efficacy.
PURPOSE: To appraise the evaluation methods for learning curve and to analyze the non-mentor-aided learning curve and early complications following the holmium laser enucleation of the prostate. MATERIALS AND METHODS: One-hundred and forty (n=140) consecutive patients who underwent HoLEP from July 2008 to July 2010 by a single surgeon (SJO) were enrolled. Perioperative clinical variables, including enucleation time, morcellation time, enucleation ratio (enucleation weight/transitional zone volume), enucleation efficacy (enucleated weight/enucleation time), enucleation ratio efficacy (enucleation ratio/enucleation time), and early complication rate were analyzed. RESULTS: Mean prostate volume was 62.7 mL (range 21-162) and preoperative International Prostate Symptom Score (IPSS) was 19.0 (4-35). Mean enucleation time and morcellation time were 49.9 ± 23.8 (S.D.) min and 11.0 ± 9.7 min, respectively. Median duration of postoperative indwelling catheter was 1 (1-7) day and median hospital stay was 1 (1-6) day. There were a total of 31 surgery-related complications in 27 patients (19.3%), and all were manageable. There was an increasing trend of enucleation efficacy in the first 50 cases. However, enucleation efficacy was linearly correlated with the prostate size (correlation coefficients, R=0.701, p<0.001). But, enucleation ratio efficacy could eliminate the confounding effect of the prostate size (R=-0.101, p=0.233). The plateau of enucleation ratio efficacy was reached around the twenty-fifth case. CONCLUSIONS: Our results demonstrated that the operative learning curve plateau is reached after about 25 cases. We propose that a more appropriate parameter for estimating the operative learning curve is enucleation ratio efficacy, rather than enucleation efficacy.
Authors: Dmitry Enikeev; Andrey Morozov; Mark Taratkin; Vincent Misrai; Enrique Rijo; Alexei Podoinitsin; Svetlana Gabdullina; Thomas R W Herrmann Journal: World J Urol Date: 2020-09-17 Impact factor: 4.226
Authors: Bernd Rosenhammer; Maximilian Schönhärl; Roman Mayr; Marco J Schnabel; Maximilian Burger; Christian Eichelberg Journal: Urol Int Date: 2020-09-02 Impact factor: 2.089
Authors: Kang Jun Cho; Hyo Sin Kim; Jun Sung Koh; Seung Bum Han; Sang Hoon Kim; Hyun Woo Kim; Su Yeon Cho; Joon Chul Kim Journal: Int Neurourol J Date: 2013-06-30 Impact factor: 2.835