Greenlight Photoselective Vaporisation of the Prostate in 133 High Surgical Risk Patients: A 5-Year Outcome Study

作     者：Ignacio Gómez García Marta Romero Molina Emilio Rubio Hidalgo Luis álvarez Buitrago Natanael García Betancourt Larissa Lara Pablo Gutierrez Antonio Sampietro Crespo Fernando álvarez Férnandez Antonio Gómez Rodríguez 

作者机构：LMR Group Madrid Spain Urology Service Hospital Río Ortega Valladolid Spain Urology Service Hospital Virgen de la Salud Toledo Spain 

出 版 物：《Open Journal of Urology》 (泌尿学期刊（英文）)

年 卷 期：2013年第3卷第2期

页      面：90-95页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Greenlight Vaporisation PVP High Risk ASA 

摘      要：Greenlight photoselective vaporisation of the prostate (GPVP) is progressively becoming an established treatment in patients with LUTS because it is a minimally invasive technique that achieves efficient haemostasis, making it the ideal technique for patients at high surgical risk. Material and Methods: To study of 133 patients with an ASA surgical risk score of 3 or 4, undergoing GPVP, with an analysis of perioperative outcome, IPSS, Qmax, IIEF-5 and complications during a five-year follow-up. Results: At 5 years the mean annual improvement in IPSS was stable, and at 5 years there was a 15.2 point improvement versus the preoperative score (p 0.05). The Qmax showed an improvement of 14.9 ml/sec and was maintained at five years after surgery (p 0.05). No patients were transfused or suffered urinary incontinence. 2.25% suffered major complications and there were no deaths. 3.1% of patients suffered de novo urgency. In the 5-year follow-up, five patients had to be reoperated. The quality of sexual health assessed by IIEF-5 before the procedure was scored at 14 points;the 5-year follow-up covering the preoperative period and all revisions did not show any worsening in the IIEF-5 score (p 0.05). Conclusions: Due to its physical characteristics, in our opinion GPVP is now the treatment of choice in patients at high surgical risk. In our series, the risk of major/minor complications and transfusions was much lower than the same risks in conventional techniques. The objective results (Qmax and quality of life questionnaire) are equivalent to conventional techniques and persist over a 5-year follow-up.