Benoit Peyronnet1, Benjamin Pradere2, Nicolas Brichart2, Thomas Bodin2, Philippe Bertrand3, Franck Bruyère4. 1. Department of Urology, CHRU TOURS, Tours, Loire Valley, France. Electronic address: peyronnetbenoit@hotmail.fr. 2. Department of Urology, CHRU TOURS, Tours, Loire Valley, France. 3. Department of Statistics, CHRU TOURS, Tours, Loire Valley, France. 4. Department of Urology, CHRU TOURS, Tours, Loire Valley, France; Université François Rabelais, PRES Center-Tours, Loire Valley, France; Center d'Innovations Technologiques, CHRU TOURS, Tours, France.
Abstract
OBJECTIVE: To devise and validate a system to categorize GreenLight photoselective vaporization of prostate (PVP) complications according to Clavien score (CS), to report complications of PVP using this categorization, and to determine risk factors. MATERIALS AND METHODS: A survey questionnaire was distributed to all participants of the second meeting of the Group of GreenLight Users. They were asked to grade PVP complications according to CS. We calculated the mode CS for each complication from the survey data to propose a categorization system for complications of PVP. Complications encountered in a large single-center cohort of 370 patients were reported according to this system. We assessed the reproducibility of CS by estimating inter-rater agreement by the Fleiss kappa. We performed univariate and multivariate analyses to determine risk factors for complications. RESULTS: Of the 67 meeting participants, 42 (62.7%) completed the survey. Overall agreement between urologists was fair (Fleiss kappa = 0.356). Among the 370 patients, 21 (5.7%) had intraoperative complications, 147 (39.7%) had postoperative complications, and 70 (18.9%) had long-term complications. Among the postoperative complications, 125 patients (33.8%) were classified as Clavien grade I, 58 (15.7%) as Clavien grade II, 4 (1.1%) as Clavien grade IIIb, 5 (1.3%) as Clavien grade IVa, 1 (0.3%) as Clavien grade IVb, and 1 (0.3%) as Clavien grade V. In multivariate analysis, the only predictor of overall complications was a polymicrobial preoperative urine culture. CONCLUSION: The grading of PVP complications by CS is fairly reproducible. We are the first to propose a system for the categorization of PVP complications. PVP complications are frequent but most often minor.
OBJECTIVE: To devise and validate a system to categorize GreenLight photoselective vaporization of prostate (PVP) complications according to Clavien score (CS), to report complications of PVP using this categorization, and to determine risk factors. MATERIALS AND METHODS: A survey questionnaire was distributed to all participants of the second meeting of the Group of GreenLight Users. They were asked to grade PVP complications according to CS. We calculated the mode CS for each complication from the survey data to propose a categorization system for complications of PVP. Complications encountered in a large single-center cohort of 370 patients were reported according to this system. We assessed the reproducibility of CS by estimating inter-rater agreement by the Fleiss kappa. We performed univariate and multivariate analyses to determine risk factors for complications. RESULTS: Of the 67 meeting participants, 42 (62.7%) completed the survey. Overall agreement between urologists was fair (Fleiss kappa = 0.356). Among the 370 patients, 21 (5.7%) had intraoperative complications, 147 (39.7%) had postoperative complications, and 70 (18.9%) had long-term complications. Among the postoperative complications, 125 patients (33.8%) were classified as Clavien grade I, 58 (15.7%) as Clavien grade II, 4 (1.1%) as Clavien grade IIIb, 5 (1.3%) as Clavien grade IVa, 1 (0.3%) as Clavien grade IVb, and 1 (0.3%) as Clavien grade V. In multivariate analysis, the only predictor of overall complications was a polymicrobial preoperative urine culture. CONCLUSION: The grading of PVP complications by CS is fairly reproducible. We are the first to propose a system for the categorization of PVP complications. PVP complications are frequent but most often minor.
Authors: Khaled Ajib; Mila Mansour; Marc Zanaty; Mansour Alnazari; Pierre-Alain Hueber; Malek Meskawi; Roger Valdivieso; Come Tholomier; Benjamin Pradere; Vincent Misrai; Dean Elterman; Kevin C Zorn Journal: Can Urol Assoc J Date: 2018-03-19 Impact factor: 1.862