Thulium Lazer ile Prostat Enükleasyonu(ThuLEP) deneyimleri

Yıl 2020, Cilt: 12 Sayı: 2, 99 - 107, 23.07.2020

Eymen Gazel , Mehmet Yılmaz , Halil Çağrı Aybal , Engin Kaya , Serdar Yalçın , Sercan Yılmaz , Onur Açıkgöz Lütfi Tunç

Öz

Giriş: 1998'den bu yana, Gilling prostatın Holmium Lazer Enükleasyonu'nu (HoLEP) ilk kez tarif ettikten sonra, prostat cerrahisinde lazer kullanımı yaygınlaşmıştır. Prostatın endoskopik cerrahilerinde Thulium lazer enükleasyonu (ThuLEP) da uygulanmaktadır. Thulium lazer cihazı şu anda Türkiye'deki sınırlı sayıda merkezde kullanılmaktadır. Bu çalışmada Türkiye’de ilk ThuLEP vakasının da gerçekleştirildiği merkezimizin sonuçlarını literatüre kazandırmayı amaçladık.

Gereç ve Yöntemler: Temmuz 2018 ile Eylül 2019 arasında ThuLEP ameliyatı olan 60 hastanın verileri retrospektif olarak tarandı . Enükleasyon süresi (ET) (dak), morselasyon süresi (MT) (min), toplam operasyon süresi (OT-toplam) (min), enükleasyon etkinliği (EE) (g / dak) ve morselasyon etkinliği (ME) (g / dak), enükle edilen doku ağırlığı (RTW) (g), enükle edilen doku yüzdesi (PWR) gibi perioperatif veriler ile intraoperatif ve postoperatif komplikasyonlar kaydedildi. Qmax, Qave, Qmax'a Kadar Süre, Voiding Süresi (VT), IPSS, QoL verileri ve postoperatif kontinans durumu postoperatif 1. ay ve 6. ay takibi ile karşılaştırıldı.

Bulgular: Postoperatif fonksiyonel sonuçları gösteren tüm parametrelerde istatistiksel olarak anlamlı iyileşme gözlendi (p <0.001). Hastaların kontinans durumu ile ilgili olarak SUI, UUI ve PMR sırasıyla% 5,% 6.64 ve% 9.96 olarak gözlendi. Bu oranların hastaların 1. ay takibinde gerilediği gözlendi. Hiçbir hastanın 6. ay takiplerinde SUI, UUI ve PMR gözlenmedi.

Sonuçlar: Bu çalışma Türkiye'den bildirilen ilk ThuLEP serisidir. ThuLEP hakkında daha geniş serilere sahip prospektif randomize çalışmaların literatüre katkı sağlayacağına inanıyoruz.

Anahtar Kelimeler

ThuLEP, prostat, lazer, thulium, Türkiye

The Experiences of Thulium laser enucleation of the prostate (ThuLEP)

Öz

Intoduction: Since 1998, after Gilling described Holmium Laser Enucleation of the Prostate (HoLEP) for the first time, laser using in prostate surgery has spread. Thulium laser enucleation of the prostate (ThuLEP) is also applied in endoscopic surgeries of the prostate. Thulium laser device is currently used in a limited number of centres in Turkey. In the present study, we aimed to contribute to the literature with the data of the cases carried out in our centre where the first case of ThuLEP was performed in Turkey.

Material and Methods: The data of 60 patients who underwent Thulep surgery between July 2018 and September 2019 were used in the retrospectively designed study. Perioperative datas such as Enucleation time (ET) (min), morcellation time (MT) (min), total operation time (OT-total) (min), enucleation efficiency (EE) (g/min) and morcellation efficiency (ME) (g/min), enucleated tissue weight (RTW) (g), enucleated tissue percentage (PWR), intraoperative and postoperative complications recorded. Parameters such as Qmax, Qave, Time to Qmax, Voiding Time (VT), IPSS, QoL data and postoperative continence status were compared postoperative 1st month and 6th month follow up.

Results: Statistically significant improvement was observed in all parameters showing functional results after the surgery (p<0.001). Regarding the continence status of patients, SUI, UUI and PMR were observed at 5%, 6.64% and 9.96%, respectively. These rates were observed to regress at the 1st month follow-up of patients. No SUI, UUI, and PMR were observed at the 6th month follow-ups of any patients.

Conclusions: The present study is the first ThuLEP series reported from Turkey. We believe that prospective randomized studies about ThuLEP with larger series would be a contribution to the literature.

Anahtar Kelimeler

ThuLEP, prostate, laser, thulium, Turkey

Kaynakça

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