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
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v79i2.478Keywords:
GreenLight, Safety, Obstructive prostatic growthAbstract
Objective: 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
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