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Comparison study of learning curve between Holmium laser enucleation of the prostate and transurethral resection of the prostate:
Is HoLEP difficult procedure in beginner urologists? |
| 순천향대학교 의과대학 비뇨기과학교실 |
| 김기홍, 김시현, 양희조, 김두상, 이창호, 전윤수 |
Introduction and Objective:
Even though there was no comparison study about the learning curve of HoLEP and other surgical modalities to treat low urinary tract symptoms, several beginner urologists have hesitation on performing Holmium laser enucleation of the prostate (HoLEP) because HoLEP had been known to have stiff learning curve. Therefore, we investigated the degree of surgical difficulty of HoLEP by comparing the learning curve of HoLEP and transurethral resection of the prostate (TURP).
Patients and methods:
Two young urologists with 2 years fellowship have performed surgical treatment for BPH . HJY performed only HoLEP, and KHK performed only TURP in all cases. From total 141 BPH patients, 72 patients were enrolled to HoLEP group and 69 patients were enrolled to TURP group. After reviewing medical records retrospectively, authors performed the cumulative sum (CUSUM) analysis in retrieval rate (RR) and enucleation ratio (ER) to compare the learning curve of HoLEP and TURP.
Results:
In terms of RR, both surgeons achieved competency under 0.13 gm/min. and for ER, the surgeon who performed HoLEP archived competency under 0.40, while TURP group archived competency under 0.35. For achieving competency of ‘RR = 0.13 gm/ml’, HoLEP group and TURP group required 12 and 23 cases, respectively. For achieving competency of ‘ER = 0.35’, HoLEP group and TURP group required 12 and 5 cases, respectively.
Conclusions:
Considering RR and ER, HoLEP is not difficult procedure compared to TURP in beginner urologists. We suggest that it is unnecessary to hesitate on performing HoLEP because of a groundless concern that HoLEP may be difficult procedure .
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keywords : benign prostatic hyperplasia, Holmium laser enucleation of the prostate, Transurethral resection of prostate |
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