2019, Number 2
Photoselective vaporization of the prostate with 180W GreenLight xps laser and MoXy fiber: Safety and efficacy in patients with obstructive prostatic growth at the Hospital General Dr. Manuel Gea González
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ABSTRACTObjective: To present our experience in relation to the safety and efficacy of the 180W Greenlight xps laser for photoselective vaporization of the prostate.
Materials and methods: A retrospective, observational, analytic, and descriptive study was conducted within the time frame of July 2014 to November 2017, evaluating technical aspects and preoperative and postoperative variables at 1, 3, and 6 months.
Results: Fifty-five patients were included in the study. Their mean age was 69 years. A total of 49.1% presented with comorbidities, 14.5% with heart disease, and 20% with an ASA III. The preoperative parameters were: IPSS 14.5 points (5-35), Qmax 7.19 ml/sec (1.5-12), prostate volume 74 cc (29.2-130), PSA 5.7 ng/ml, and Foley catheter placement (54%). Laser use, time with catheter, previous infections, and previous biopsy were described, as were intraoperative complications (10.8%), postoperative complications (27.3%), Clavien-Dindo (C-D) I (80.2%), C-D II (6.6%), and C-D IIIa (13.2%). Postoperative control at 6 months was: Qmax 17.2 ml/sec (10.2-34.4) (p=0.01) and IPSS 4.2 points (0-19) (p=0.02). Surgical reintervention was performed in 3.6% of the patients, hospital stay was 1.5 days, and the mortality rate was 0%.
Conclusions: Photoselective vaporization of the prostate with the GreenLight laser is a safe surgical technique with good results in high-risk surgical patient populations. Complications are similar to those when utilizing the gold standard, but patients taking anticoagulants and antiaggregants can be operated on with the technique and hospital stay is short. Studies with long-term follow-up are needed.
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