UNIFIED CRITERIA OF POSTOPERATIVE COMPLICATIONS IN ASSESSING THE EFFICIENCY AND SAFETY OF SURGICAL METHODS FOR THE TREATMENT OF BENIGN PROSTATE HYPERPLASIA
Keywords:
BPH, complications, systematization, Clavien-Dindo classification, OETA, URP, HoLEP, morbidity, prostate hyperplasiaAbstract
Unification of postoperative complications criteria of surgical modalities for the treatment of benign prostatic hyperplasia (BPH) based on the Clavien-Dindo classification. Efficacy and safety evaluation of different surgical modalities for the BPH treatment by systematizing postoperative complications. 150 patients with BPH were divided into three groups depending on the surgical modality of prostatic hyperplasia. Group 1 consisted of 60 (40%) patients who underwent open transvesical simple prostatectomy (OETA), Group 2 - 50 (33.3%) patients who underwent transurethral resection of the prostate (TURP), Group 3 - 40 (26.7%) patients underwent holmium laser enucleation of the prostate (HoLEP). The Clavien-Dindo classification was used to adapt the assessment of postoperative complications of BPH operative therapy. To use the Clavien-Dindo classification for an unbiased evaluation of surgical treatment quality and systematization of complications, it must first be adapted, taking into account the method specifics and the postoperative period. OETA is an effective method to treat BPH but is accompanied by a longer period of hospitalization compared to TURP and HoLEP, more severe complications, conclusively more often requiring additional interference. In terms of trauma, blood transfusions frequency, and the length of hospital stay, the results of TURP are comparable to those of HoLEP but are inferior in morbidity.
References
Das AK. Techniques and innovative technologies for the treatment of BPH. Can J Urol. 2019 Aug;26(4 Suppl 1):1. PMID: 31481141.
Freyer PG. A new method of performing prostatectomy. Lancet: 1900; 1: 774.
Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, Lack N, Stief CG; Urology Section of the Bavarian Working Group for Quality Assurance. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol. 2008 Jul;180(1):246-9. doi: 10.1016/j.juro.2008.03.058. Epub 2008 May 21. PMID: 18499179.
Gilling, P. J., & Fraundorfer, M. R. (1998). Holmium laser prostatectomy: a technique in evolution. Current opinion in urology, 8(1), 11–15.
Michalak J, Tzou D, Funk J. HoLEP: the gold standard for the surgical management of BPH in the 21(st) Century. Am J Clin Exp Urol. 2015 Apr 25;3(1):36-42. PMID: 26069886; PMCID: PMC4446381.
EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94- 92671-13-4.
Enikeev D, Okhunov Z, Rapoport L, Taratkin M, Enikeev M, Snurnitsyna O, Capretz T, Inoyatov J, Glybochko P. Novel Thulium Fiber Laser for Enucleation of Prostate: A Retrospective Comparison with Open Simple Prostatectomy. J Endourol. 2019 Jan;33(1):16- 21. doi: 10.1089/end.2018.0791. PMID: 30489154.
Peshekhonov K.S., Shpilenia E.S., Komyakov B.K., Burlaka O.O., Sargsyan M.S. Endoscopic treatment of prostatic hyperplasia in elderly patients: a comparative analysis of resection and enucleation technique. Urology Herald. 2020;8(1):25-38. (In Russ.). https://doi.org/10.21886/2308-6424-2020-8-1-25-38.
Dindo D., Demartines N., Clavien P.A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery. 2004; 240:205-13. DOI: 10.1097/01.sla.0000133083.54934.ae.
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi
M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009 Aug;250(2):187-96. doi: 10.1097/SLA.0b013e3181b13ca2. PMID: 19638912.
11.12. De Cassai A, Boscolo A, Tonetti T, Ban I, Ori C. Assignment of ASA-physical status relates to anesthesiologists' experience: a survey-based national-study. Korean J Anesthesiol. 2019 Feb;72(1):53-59.
Laguna MP, Beemster P, Kumar P et al (2009) Perioperative morbidity of laparoscopic cryoablation of small renal masses with ultrathin probes: a European multicentre experience. Eur Urol 56:355–361.
Mamoulakis C, Efthimiou I, Kazoulis S, Christoulakis I, Sofras F. The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol. 2011 Apr;29(2):205-10. doi: 10.1007/s00345-010- 0566-y. Epub 2010 May 12. PMID: 20461386; PMCID: PMC3062770.
Sagen E, Namnuan RO, Hedelin H, Nelzén O, Peeker R. The morbidity associated with a TURP procedure in routine clinical practice, as graded by the modified Clavien-Dindo system. Scand J Urol. 2019 Aug;53(4):240-245. doi: 10.1080/21681805.2019.1623312. Epub 2019 Jun 3. PMID: 31156002.
Omar MI, Lam TB, Alexander CE, Graham J, Mamoulakis C, Imamura M, et al. Systematic review and meta-analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP). BJU Int. 2014; 113:24– 35.
Rabbani F, Yunis LH, Pinochet R, Nogueira L, Vora KC, Eastham JA, et al. Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. Eur Urol 2010;57:371-86.
Loppenberg B, Noldus J, Holz A, Palisaar RJ. Reporting complications after open radical retropubic prostatectomy using the Martin criteria. J Urol 2010; 184:944-8.
Mamoulakis C, Ubbink DT, de la Rosette JJMCH. Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol. 2009;56:798–809.
Tang Y, Li J, Pu C, Bai Y, Yuan H, Wei Q, et al. Bipolar transurethral resection versus monopolar transurethral resection for benign prostatic hypertrophy: a systematic review and meta-analysis. J Endourol. 2014;28:1107–14.
Michalak J, Tzou D, Funk J. HoLEP: the gold standard for the surgical management of BPH in the 21(st) Century. Am J Clin Exp Urol. 2015 Apr 25;3(1):36-42. PMID: 26069886; PMCID: PMC4446381.
Yalçın S, Yılmaz S, Gazel E, Kaya E, Aydoğan TB, Aybal HÇ, Tunç L. Holmium laser enucleation of theMitr prostate for the treatment of size-independent BPH: A single-center experience of 600 cases. Turk J Urol. 2020 Jan 17;46(3):219-225. doi: 10.5152/tud.2020.19235. PMID: 32053095; PMCID: PMC7219966.
Акилов Ф. А., Гиясов Ш. И., Мухтаров Ш. Т., Насыров Ф. Р., Мирхамидов Д. Х. Оценка осложнений эндоскопической хирургии нефролитиаза с позиций классификации Clavien-Dindo // ЭКУ. 2012. №3.
Гиясов Ш.И., Акилов Ф.А. Трудности в систематизации послеоперацонных осложнений эндоскопического лечения уролитиаза и пути их решения. Вестник урологии. 2018;6(1):5-17. https://doi.org/10.21886/2308-6424-2018-6-1-5-17.
Foster HE, Dahm P, Kohler TS, Lerner LB, Parsons JK, Wilt TJ, McVary KT. Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Amendment 2019. J Urol. 2019 Sep;202(3):592-598. doi: 10.1097/JU.0000000000000319. Epub 2019 Aug 8. PMID: 31059668.
Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)--incidence, management, and prevention. Eur Urol. 2006 Nov;50(5):969-79; discussion 980. doi: 10.1016/j.eururo.2005.12.042. Epub 2006 Jan 30. PMID: 16469429.
Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, Speakman MJ, Stief CG. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol. 2010 Sep;58(3):384-97. doi: 10.1016/j.eururo.2010.06.005. Epub 2010 Jun 11. PMID: 20825758.
Glybochko PV, Alyaev YG, Rapoport LM, Enikeev DV, Okhunov Z, Netsch C, Spivak LG, Taratkin MS. [Endoscopic enucleation of the prostate: a short-term trend or a new treatment standard?]. Urologiia. 2018 May;(2):130-133. Russian. PMID: 29901308.
Li M, Qiu J, Hou Q, Wang D, Huang W, Hu C, Li K, Gao X. Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. PLoS One. 2015 Mar 31;10(3):e0121265. doi: 10.1371/journal.pone.0121265. PMID: 5826453; PMCID: PMC4380430.
Ahyai SA, Chun FK, Lehrich K, Dahlem R, Zacharias MS, Fisch MM, Kuntz RM. Transurethral holmium laser enucleation versus transurethral resection of the prostate and simple open prostatectomy--which procedure is faster? J Urol. 2012 May;187(5):1608-13. doi: 10.1016/j.juro.2011.12.107. Epub 2012 Mar 14. PMID: 22425091.
Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N, Stief CG, Reich O. Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol. 2007 Apr;177(4):1419-22. doi: 10.1016/j.juro.2006.11.062. PMID: 17382744.
Biktimirov RG, Martov AG, Biktimirov TR, Kaputovskij AA. [The current status of surgical treatment of benign prostatic hyperplasia with volume over 80]. Urologiia. 2019 Jul;(3):128-133. Russian. PMID: 31356026.
