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Published in: World Journal of Urology 5/2018

01-05-2018 | Original Article

Comparison between open simple prostatectomy and green laser enucleation of the prostate for treating large benign prostatic hyperplasia: a single-centre experience

Authors: Vincent Misraï, Marie Pasquie, Benoit Bordier, Benjamin Elman, Jean Michel Lhez, Julien Guillotreau, Kevin Zorn

Published in: World Journal of Urology | Issue 5/2018

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Abstract

Purpose

This study sought to compare perioperative outcomes and morbidities for open simple prostatectomy (OSP) and endoscopic green laser enucleation of the prostate (GreenLEP).

Methods

In a single department, all consecutive patients who underwent OSP between January 2005 and December 2010 were retrospectively reviewed, and all consecutive patients undergoing GreenLEP between July 2013 and January 2017 were prospectively enrolled. Perioperative data, information regarding early postoperative complications for up to 6 months and outcomes were collected and retrospectively compared.

Results

Overall, 204 patients were enrolled in each group. The baseline characteristics of patients in both groups were comparable. Intraoperative time was significantly longer for the OSP group than for the GreenLEP group (67 versus 60 min; p < 0.0001). The OSP group had significantly longer catheterisation (5 versus 2 days; p < 0.0001) and hospitalisation times (7 versus 2 days; p < 0.0001) than the GreenLEP group. The overall rate of complications was significantly higher after OSP than after GreenLEP (37.2 versus 20.6%; p = 0.0003); both Clavien–Dindo grade 3a complications (8.8 versus 0.98%) and Clavien–Dindo grade 3b complications (2.4 versus 3.4%) were observed. The transfusion rate was higher after OSP than after GreenLEP (8.3 versus 0.5%; p = 0.0001). The rehospitalisation rate was similar for both groups (7.8 versus 8.3%; p = 0.99).

Conclusions

The results of this single-centre cohort study confirm those of similar prior investigations addressing endoscopic enucleation of the prostate. Compared with OSP, GreenLEP may have a more desirable perioperative profile with lower morbidity. In contrast, GreenLEP and OSP were associated with similar 6-month rehospitalisation rates.
Literature
1.
go back to reference Lukacs B, Cornu JN, Aout M, Tessier N, Hodée C, Haab F, Cussenot O, Merlière Y, Moysan V, Vicaut E (2013) Management of lower urinary tract symptoms related to benign prostatic hyperplasia in real-life practice in France: a comprehensive population study. Eur Urol 64:493–501CrossRefPubMed Lukacs B, Cornu JN, Aout M, Tessier N, Hodée C, Haab F, Cussenot O, Merlière Y, Moysan V, Vicaut E (2013) Management of lower urinary tract symptoms related to benign prostatic hyperplasia in real-life practice in France: a comprehensive population study. Eur Urol 64:493–501CrossRefPubMed
3.
go back to reference Cornu JN, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, McVary K, Novara G, Woo H, Madersbacher S (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67:1066–1096CrossRefPubMed Cornu JN, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, McVary K, Novara G, Woo H, Madersbacher S (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67:1066–1096CrossRefPubMed
4.
go back to reference Bultitude M, Challacombe B (2015) Simple prostatectomy: a step too far for laparoscopy? Eur Urol 68:95–96CrossRefPubMed Bultitude M, Challacombe B (2015) Simple prostatectomy: a step too far for laparoscopy? Eur Urol 68:95–96CrossRefPubMed
5.
go back to reference Naspro R, Suardi N, Salonia A, Scattoni V, Guazzoni G, Colombo R, Cestari A, Briganti A, Mazzoccoli B, Rigatti P, Montorsi F (2006) Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 50:563–568CrossRefPubMed Naspro R, Suardi N, Salonia A, Scattoni V, Guazzoni G, Colombo R, Cestari A, Briganti A, Mazzoccoli B, Rigatti P, Montorsi F (2006) Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 50:563–568CrossRefPubMed
6.
go back to reference Kuntz RM, Lehrich K, Ahyai SA (2008) Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 53:160–166CrossRefPubMed Kuntz RM, Lehrich K, Ahyai SA (2008) Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 53:160–166CrossRefPubMed
8.
go back to reference Meskawi M, Hueber PA, Valdivieso R, Bruyere F, Misrai V, Fournier G, Munver R, Sivarajan G, Rutman M, Te AE, Chughtai B, Elterman D, Martel T, Azizi M, Karakiewicz PI, Zorn KC (2017) Multicenter international experience of 532 nm-laser photo-vaporization with Greenlight XPS in men with large prostates (prostate volume > 100 cc). World J Urol 35:1603–1609CrossRefPubMed Meskawi M, Hueber PA, Valdivieso R, Bruyere F, Misrai V, Fournier G, Munver R, Sivarajan G, Rutman M, Te AE, Chughtai B, Elterman D, Martel T, Azizi M, Karakiewicz PI, Zorn KC (2017) Multicenter international experience of 532 nm-laser photo-vaporization with Greenlight XPS in men with large prostates (prostate volume > 100 cc). World J Urol 35:1603–1609CrossRefPubMed
9.
go back to reference Gomez Sancha F, Rivera VC, Georgiev G, Botsevski A, Kotsev J, Herrmann T (2015) Common trend: move to enucleation—is there a case for GreenLight enucleation? Development and description of the technique. World J Urol 33:539–547CrossRefPubMed Gomez Sancha F, Rivera VC, Georgiev G, Botsevski A, Kotsev J, Herrmann T (2015) Common trend: move to enucleation—is there a case for GreenLight enucleation? Development and description of the technique. World J Urol 33:539–547CrossRefPubMed
10.
go back to reference Elshal AM, Elkoushy MA, El-Nahas AR, Shoma AM, Nabeeh A, Carrier S, Elhilali MM (2015) GreenLight™ laser (XPS) photoselective vapo-enucleation versus holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic hyperplasia: a randomized controlled study. J Urol 193:927–934CrossRefPubMed Elshal AM, Elkoushy MA, El-Nahas AR, Shoma AM, Nabeeh A, Carrier S, Elhilali MM (2015) GreenLight™ laser (XPS) photoselective vapo-enucleation versus holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic hyperplasia: a randomized controlled study. J Urol 193:927–934CrossRefPubMed
11.
go back to reference Misrai V, Kerever S, Phe V, Zorn KC, Peyronnet B, Rouprêt M (2016) Direct comparison of GreenLight laser XPS photoselective prostate vaporization and GreenLight laser en bloc enucleation of the prostate in enlarged glands greater than 80 ml: a study of 120 patients. J Urol 195:1027–1032CrossRefPubMed Misrai V, Kerever S, Phe V, Zorn KC, Peyronnet B, Rouprêt M (2016) Direct comparison of GreenLight laser XPS photoselective prostate vaporization and GreenLight laser en bloc enucleation of the prostate in enlarged glands greater than 80 ml: a study of 120 patients. J Urol 195:1027–1032CrossRefPubMed
12.
go back to reference Misraï V, Faron M, Guillotreau J, Bruguière E, Bordier B, Shariat SF, Rouprêt M (2014) Assessment of the learning curves for photoselective vaporization of the prostate using GreenLight™ 180-watt-XPS laser therapy: defining the intra-operative parameters within a prospective cohort. World J Urol 32:539–544CrossRefPubMed Misraï V, Faron M, Guillotreau J, Bruguière E, Bordier B, Shariat SF, Rouprêt M (2014) Assessment of the learning curves for photoselective vaporization of the prostate using GreenLight™ 180-watt-XPS laser therapy: defining the intra-operative parameters within a prospective cohort. World J Urol 32:539–544CrossRefPubMed
13.
go back to reference Misrai V, Bordier B, Guillotreau J (2017) Assessment of the learning curves for intravesical adenoma morcellation using Piranha(©) device during endoscopic enucleation. Prog Urol 27:33–37CrossRefPubMed Misrai V, Bordier B, Guillotreau J (2017) Assessment of the learning curves for intravesical adenoma morcellation using Piranha(©) device during endoscopic enucleation. Prog Urol 27:33–37CrossRefPubMed
14.
go back to reference Peyronnet B, Robert G, Comat V, Rouprêt M, Gomez-Sancha F, Cornu JN, Misrai V (2017) Learning curves and perioperative outcomes after endoscopic enucleation of the prostate: a comparison between GreenLight 532-nm and holmium lasers. World J Urol 35:973–983CrossRefPubMed Peyronnet B, Robert G, Comat V, Rouprêt M, Gomez-Sancha F, Cornu JN, Misrai V (2017) Learning curves and perioperative outcomes after endoscopic enucleation of the prostate: a comparison between GreenLight 532-nm and holmium lasers. World J Urol 35:973–983CrossRefPubMed
15.
go back to reference Witherington R, Shelor WC (1974) Suprapubic prostatectomy. Modified Hryntschak technique. Urology 4:550–556CrossRefPubMed Witherington R, Shelor WC (1974) Suprapubic prostatectomy. Modified Hryntschak technique. Urology 4:550–556CrossRefPubMed
16.
go back to reference Mitropoulos D, Artibani W, Biyani CS, Bjerggaard Jensen J, Remzi M, Rouprêt M, Truss M (2014) Quality assessment of partial nephrectomy complications reporting using EAU standardised quality criteria. Eur Urol 66:522–526CrossRefPubMed Mitropoulos D, Artibani W, Biyani CS, Bjerggaard Jensen J, Remzi M, Rouprêt M, Truss M (2014) Quality assessment of partial nephrectomy complications reporting using EAU standardised quality criteria. Eur Urol 66:522–526CrossRefPubMed
17.
go back to reference Peyronnet B, Cornu JN, Rouprêt M, Bruyere F, Misrai V (2015) Trends in the use of the GreenLight laser in the surgical management of benign prostatic obstruction in France over the past 10 years. Eur Urol 67:1193–1195CrossRefPubMed Peyronnet B, Cornu JN, Rouprêt M, Bruyere F, Misrai V (2015) Trends in the use of the GreenLight laser in the surgical management of benign prostatic obstruction in France over the past 10 years. Eur Urol 67:1193–1195CrossRefPubMed
18.
go back to reference Cockrell R, Lee DI (2017) Robot-assisted simple prostatectomy: expanding on an established operative approach. Curr Urol Rep 18:37CrossRefPubMed Cockrell R, Lee DI (2017) Robot-assisted simple prostatectomy: expanding on an established operative approach. Curr Urol Rep 18:37CrossRefPubMed
19.
go back to reference Varkarakis I, Kyriakakis Z, Delis A, Protogerou V, Deliveliotis C (2004) Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 64:306CrossRefPubMed Varkarakis I, Kyriakakis Z, Delis A, Protogerou V, Deliveliotis C (2004) Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 64:306CrossRefPubMed
20.
go back to reference Tubaro A, Carter S, Hind A, Vicentini C, Miano L (2001) A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol 166:172CrossRefPubMed Tubaro A, Carter S, Hind A, Vicentini C, Miano L (2001) A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol 166:172CrossRefPubMed
21.
go back to reference Autorino R, Zargar H, Mariano M et al (2015) Perioperative outcomes of robotic and laparoscopic simple prostatectomy: a European-American multi-institutional analysis. Eur Urol 68:86–94CrossRefPubMed Autorino R, Zargar H, Mariano M et al (2015) Perioperative outcomes of robotic and laparoscopic simple prostatectomy: a European-American multi-institutional analysis. Eur Urol 68:86–94CrossRefPubMed
22.
go back to reference Robert G, Cornu JN, Fourmarier M, Saussine C, Descazeaud A, Azzouzi AR, Vicaut E, Lukacs B (2016) Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP). BJU Int 117:495–499CrossRefPubMed Robert G, Cornu JN, Fourmarier M, Saussine C, Descazeaud A, Azzouzi AR, Vicaut E, Lukacs B (2016) Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP). BJU Int 117:495–499CrossRefPubMed
23.
go back to reference Bachmann A, Muir GH, Collins EJ, Choi BB, Tabatabaei S, Reich OM, Gómez-Sancha F, Woo HH (2012) 61 180-W XPS GreenLight laser therapy for benign prostate hyperplasia: early safety, efficacy, and perioperative outcome after 201 procedures. Eur Urol 61:600–607CrossRefPubMed Bachmann A, Muir GH, Collins EJ, Choi BB, Tabatabaei S, Reich OM, Gómez-Sancha F, Woo HH (2012) 61 180-W XPS GreenLight laser therapy for benign prostate hyperplasia: early safety, efficacy, and perioperative outcome after 201 procedures. Eur Urol 61:600–607CrossRefPubMed
24.
go back to reference Endo F, Shiga Y, Minagawa S, Iwabuchi T, Fujisaki A, Yashi M, Hattori K, Muraishi O (2010) Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology 76:1451–1455CrossRefPubMed Endo F, Shiga Y, Minagawa S, Iwabuchi T, Fujisaki A, Yashi M, Hattori K, Muraishi O (2010) Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology 76:1451–1455CrossRefPubMed
25.
go back to reference Thomas JA, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, Grimm MO, Benejam J, Stolzenburg JU, Riddick A, Pahernik S, Roelink H, Ameye F, Saussine C, Bruyère F, Loidl W, Larner T, Gogoi NK, Hindley R, Muschter R, Thorpe A, Shrotri N, Graham S, Hamann M, Miller K, Schostak M, Capitán C, Knispel H, Bachmann A (2016) A multicenter randomized noninferiority trial comparing GreenLight-XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two-yr outcomes of the GOLIATH study. Eur Urol 69:94–102CrossRefPubMed Thomas JA, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, Grimm MO, Benejam J, Stolzenburg JU, Riddick A, Pahernik S, Roelink H, Ameye F, Saussine C, Bruyère F, Loidl W, Larner T, Gogoi NK, Hindley R, Muschter R, Thorpe A, Shrotri N, Graham S, Hamann M, Miller K, Schostak M, Capitán C, Knispel H, Bachmann A (2016) A multicenter randomized noninferiority trial comparing GreenLight-XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two-yr outcomes of the GOLIATH study. Eur Urol 69:94–102CrossRefPubMed
Metadata
Title
Comparison between open simple prostatectomy and green laser enucleation of the prostate for treating large benign prostatic hyperplasia: a single-centre experience
Authors
Vincent Misraï
Marie Pasquie
Benoit Bordier
Benjamin Elman
Jean Michel Lhez
Julien Guillotreau
Kevin Zorn
Publication date
01-05-2018
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 5/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2192-z

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