Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Prospective study comparing laparoscopic and open adenomectomy: Surgical and fun...
Journal Information
Vol. 41. Issue 1.
Pages 47-54 (January - February 2017)
Share
Share
Download PDF
More article options
ePub
Visits
4
Vol. 41. Issue 1.
Pages 47-54 (January - February 2017)
Original article
DOI: 10.1016/j.acuroe.2016.11.002
Prospective study comparing laparoscopic and open adenomectomy: Surgical and functional results
Estudio prospectivo comparativo entre adenomectomía laparoscópica y abierta: resultados operatorios y funcionales
Visits
...
A. Garcia-Seguia,
Corresponding author
agarciasegui@gmail.com

Corresponding author.
, J.C. Angulob
a Servicio de Urología, Hospital General Universitario de Elche, Elche, Alicante, Spain
b Servicio de Urología, Hospital Universitario de Getafe, Departamento Clínico, Universidad Europea de Madrid, Laureate Universities, Getafe, Madrid, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (4)
Table 1. Demographic data and preoperative parameters.
Table 2. Preoperative data.
Table 3. Early complications.
Table 4. Functional results.
Show moreShow less
Abstract
Introduction

Open adenomectomy (OA) is the surgery of choice for large volume benign prostatic hyperplasia, and laparoscopic adenomectomy (LA) represents a minimally invasive alternative. We present a long-term, prospective study comparing both techniques.

Patients and methods

The study consecutively included 199 patients with benign prostatic hyperplasia and prostate volumes >80g who were followed for more than 12 months. The patients underwent OA (n=97) or LA (n=102). We recorded and compared demographic and perioperative data, functional results and complications using a descriptive statistical analysis.

Results

The mean age was 69.2±7.7 years (range 42–87), and the mean prostate volume (measured by TRUS) was 112.1±32.7mL (range 78–260). There were no baseline differences among the groups in terms of age, ASA scale, prostate volume, PSA levels, Qmax, IPSS, QoL or treatments prior to the surgery. The surgical time (p<.0001) and catheter time (p<0.0002) were longer in the LA group. Operative bleeding (p<0.0001), transfusion rate (p=0.0015) and mean stay (p<0.0001) were significantly lower in the LA group. The LA group had a lower rate of complications (p=0.04), but there were no significant differences between the groups in terms of major complications (Clavien score3) (p=0.13) or in the rate of late complications (at one year) (p=0.66). There were also no differences between the groups in the functional postoperative results: IPSS (p=0.17), QoL (p=0.3) and Qmax (p=0.17).

Conclusions

LA is a reasonable, safe and effective alternative that results in less bleeding, fewer transfusions, shorter hospital stays and lower morbidity than OA. LA has similar functional results to OA, at the expense of longer surgical times and longer catheter times.

Keywords:
Prostate
Benign prostate hyperplasia
Laparoscopy
Adenomectomy
Quality of life
Surgical results
Complications
Resumen
Introducción

La adenomectomía abierta (AA) es el tratamiento quirúrgico de elección para la hipertrofia prostática benigna de gran volumen, y la adenomectomía laparoscópica (AL) supone una alternativa mínimamente invasiva. Presentamos un estudio prospectivo comparativo a largo plazo entre ambas técnicas.

Pacientes y métodos

Se incluyeron 199 pacientes consecutivos con hipertrofia benigna de próstata de volumen prostático>80g y un seguimiento>12meses, intervenidos mediante AA (n=97) o AL (n=102). Se registraron y compararon datos demográficos, perioperatorios, resultados funcionales y complicaciones empleando un análisis estadístico descriptivo.

Resultados

La media de edad fue de 69,2±7,7 años (rango 42-87) y el volumen de la próstata por ETR de 112,1±32,7mL (rango 78-260). No hubo diferencias basales entre los grupos con respecto a edad, escala de ASA, volumen prostático, PSA, Qmáx, IPSS, CdV o tratamientos previos a la intervención. El tiempo operatorio (p<0,0001) y el tiempo de sonda (p<0,0002) fueron mayores en el grupo AL. El sangrado operatorio (p<0,0001), la tasa de transfusión (p=0,0015) y la estancia media (p<0,0001) fueron significativamente menores en el grupo laparoscópico. El grupo de AL tuvo menor tasa de complicaciones (p=0,04), pero no hubo diferencias significativas entre grupos respecto a complicaciones mayores (Clavien3) (p=0,13) o en la tasa de complicaciones tardías (al año) (p=0,66). Tampoco hubo diferencias entre grupos en los resultados funcionales postoperatorios: IPSS (p=0,17), CdV (p=0,3) y Qmáx (p=0,17).

Conclusiones

La AL representa una alternativa razonable, segura y eficaz que aporta menor sangrado, menos transfusiones, menor estancia hospitalaria y menor morbilidad que la AA, con resultados funcionales equivalentes, a expensas de un tiempo operatorio prolongado y un mayor período de sonda.

Palabras clave:
Próstata
Hipertrofia benigna de próstata
Laparoscopia
Adenomectomía
Calidad de vida
Resultados operativos
Complicaciones

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos