%0 Journal Article
%T Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate
%A Jeong
%A Chang Wook
%A Oh
%A Jin Kyu
%A Cho
%A Min Chul
%A Bae
%A Jung-Bum
%A Oh
%A Seung-June
%J International braz j urol
%D 2012
%I Sociedade Brasileira de Urologia
%R 10.1590/S1677-55382012000300009
%X purpose: to appraise the evaluation methods for learning curve and to analyze the non-mentor-aided learning curve and early complications following the holmium laser enucleation of the prostate. materials and methods:one-hundred and forty (n=140) consecutive patients who underwent holep from july 2008 to july 2010 by a single surgeon (sjo) were enrolled. perioperative clinical variables, including enucleation time, morcellation time, enucleation ratio (enucleation weight/transitional zone volume), enucleation efficacy (enucleated weight/enucleation time), enucleation ratio efficacy (enucleation ratio/enucleation time), and early complication rate were analyzed. results: mean prostate volume was 62.7 ml (range 21-162) and preoperative international prostate symptom score (ipss) was 19.0 (4-35). mean enucleation time and morcellation time were 49.9¡À23.8 (s.d.) min and 11.0¡À9.7 min, respectively. median duration of postoperative indwelling catheter was 1 (1-7) day and median hospital stay was 1 (1-6) day. there were a total of 31 surgery-related complications in 27 patients (19.3%), and all were manageable. there was an increasing trend of enucleation efficacy in the first 50 cases. however, enucleation efficacy was linearly correlated with the prostate size (correlation coefficients, r=0.701, p<0.001). but, enucleation ratio efficacy could eliminate the confounding effect of the prostate size (r=-0.101, p=0.233). the plateau of enucleation ratio efficacy was reached around the twenty-fifth case. conclusions: our results demonstrated that the operative learning curve plateau is reached after about 25 cases. we propose that a more appropriate parameter for estimating the operative learning curve is enucleation ratio efficacy, rather than enucleation efficacy.
%K prostatic hyperplasia
%K lasers
%K solid-state
%K prostatectomy
%K learning curve.
%U http://www.scielo.br/scielo.php?script=sci_abstract&pid=S1677-55382012000300009&lng=en&nrm=iso&tlng=en