Contemporary monopolar and bipolar transurethral resection of the prostate: prospective assessment of complications using the Clavien system
Contemporary monopolar and bipolar transurethral resection of the prostate: prospective assessment of complications using the Clavien system
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DOI：
10.1007/s11255-013-0476-1
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发表时间：
2013-08-01
影响因子：
2
通讯作者：
Tubaro, Andrea
中科院分区：
文献类型：
--
作者：
De Nunzio, Cosimo;Lombardo, Riccardo;Tubaro, Andrea
最近提出了Clavien系统的改良版本，以允许对经尿道前列腺切除术（TURP）相关并发症进行标准化评估。本多中心研究的目的是验证该评估工具在接受单极或双极TURP. CONCENTRATION患者队列中的使用，从2011年4月至2012年3月在5家意大利机构接受TURP的患者前瞻性纳入本研究。记录术后1个月内发生的并发症，并根据改良的Clavien系统进行评分。采用单因素和二因素Logistic回归分析方法对295例患者进行统计学分析。总体而言，44例患者记录了47例并发症。接受单极TURP的患者（27例患者; 9.2%）与接受双极TURP的患者（17例患者; 5.2%，p = 0.142）之间的术后并发症无差异。总体围手术期发病率为15.5%。大部分并发症为Clavien I型（37例; 78%）和II型（6例; 12%）。高级并发症很少，如下：Clavien IIIb型2例（4%），IV型2例（4%）。未报告TURP相关死亡。在单极TURP组中，手术时间较长（OR 1.024; 95% CI 1.007-1.040，p = 0.004）是术后并发症的独立预测因素，改良的Clavien系统可以被认为是TURP患者术后并发症分级的实用且易于应用的工具。我们的研究结果证实TURP是一种安全的手术，围手术期发病率最低。
A modified version of the Clavien system has been recently suggested to allow a standardized assessment of complications associated with transurethral resection of the prostate (TURP). Aim of this multicentre study was to validate the use of this assessment tool in a contemporary cohort of patients undergoing monopolar or bipolar TURP.Consecutive patients undergoing TURP in five Italian institutions from April 2011 to March 2012 were prospectively included in this study. Complications occurring within first postoperative month were recorded and graded according to the modified Clavien system. Univariate and binary logistic regression analysis were used for statistical analysis.Two hundred and ninety-five patients were included in the study. Overall, 47 complications were recorded in 44 patients. There was no difference in terms of postoperative complications between those who underwent monopolar TURP (27 pts; 9.2 %) versus those who underwent bipolar TURP (17 pts; 5.2 %, p = 0.142). Overall perioperative morbidity rate was 15.5 %. Most of the complications were Clavien type I (37 cases; 78 %) and II (6 cases; 12 %). High-grade complications were few as follows: Clavien type IIIb in two cases (4 %) and IV in two cases (4 %). No TURP-related deaths were reported. In the monopolar TURP group, a longer-operative time (OR 1.024; 95 % CI 1.007-1.040, p = 0.004) is an independent predictors of postoperative complications.A modified Clavien system can be considered a practical and easily applicable tool in grading postoperative complications in patients undergoing TURP. Our findings confirm that TURP is a safe procedure associated with minimal perioperative morbidity.