Application of Clavien- Dindo classification for comparing complications of three endoscopic procedures for benign prostatic hyperplasia
- VernacularTitle:三种腔镜前列腺切除手术并发症比较及Clavien-Dindo分级应用
- Author:
Fangzhen CAI
1
;
Chaohong CHEN
;
Jianyu ZHNAG
Author Information
1. 福建医科大学附属第二医院泌尿外科
- Keywords:
transurethral resection of prostate;
bipolar plasmakinetic resection of the prostate;
holmium laser enucleation of the prostate;
complications;
Clavien-Dindo classification
- From:
Journal of Southern Medical University
2015;(9):1344-1348
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the incidences of complications associated with 3 different endoscopic procedures, namely transurethral resection of prostate (TURP), bipolar plasmakinetic resection of the prostate (PKRP), and holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) and assess the clinical value of the Clavien-Dindo classification system for standardizing the evaluation of the complications. Methods Between January 2010 and December 2013, a total of 625 patients with BPH scheduled for endoscopic surgery underwent TURP (214 cases), PKRP (207 cases), or HoLEP (204 cases). The complications were recorded in each group and analyzed using the Clavien-Dindo classification system. Results There was no significant difference in the baseline data among the 3 groups (P>0.05). TURP was associated with a higher total incidence rate of complications than PKRP and HoLEP, and the incidences of electrolyte disturbance, massive intraoperative hemorrhage, urinary irritation symptom, urinary blockage, transurethral resection syndrome (TRUS), and erectile dysfunction (ED) differed significantly among the 3 groups (P<0.05). According to Clavien-Dindo classification, the incidence of grade II complications was significantly higher in TURP group than in PKRP and HoLEP groups (P<0.05), and that of grades III and IV complications was significantly higher in TURP group than in HoLEP group (P<0.05);no significant difference was found in grade I or V complications among the 3 groups (P>0.05). Conclusion According to the results of Clavien-Dindo classification analysis, PKRP and HoLEP are associated with fewer complications with a better safety profile in the treatment of BPH. The current Clavien-Dindo classification system can contribute to standardized evaluation of surgical complications but still needs further modifications for better performance.
