Application of the Modified Clavien Classification System to 120W Greenlight High-Performance System Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia: Is It Useful for Less-Invasive Procedures?
권오성, 정민영, 조성용, 손환철, 박소현,
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권오성 ( Kwon Oh-Seong )
SMG-SNU Boramae Medical Center Department of Urology
정민영 ( Jeong Min-Young )
SMG-SNU Boramae Medical Center Department of Urology
조성용 ( Cho Sung-Yong )
SMG-SNU Boramae Medical Center Department of Urology
손환철 ( Son Hwan-Cheol )
SMG-SNU Boramae Medical Center Department of Urology
박소현 ( Park So-Hyun )
Harvard School of Dental Medicine
KMID : 0358320130540040239
Abstract
Purpose: To evaluate the accuracy and applicability of the modified Clavien classification system (CCS) in evaluating complications following photoselective vaporization of the prostate by use of the 120W GreenLight high-performance system (HPS-PVP).
Materials and Methods: The medical records of 342 men who underwent HPS-PVP were retrospectively analyzed. Patients were older than 40 years and had a prostate volume >30 mL and an International Prostate Symptom Score (IPSS) ≥8. Patients with prostatic malignancy, neurogenic bladder, urethral stricture, large postvoid residual volume (>250 mL), previous prostatic surgery, or urinary tract infection were excluded. All operations were done by a single surgeon, and patients were followed up for uroflowmetry and IPSS postoperatively. All complications were recorded and classified according to the modified CCS, and methods of management were also recorded.
Results: The patients’ mean age was 71.6±7.3 years; mean prostate volume was 50.0±17.0 mL, and 95 cases (27.7%) had volumes greater than 70 mL. The mean total IPSS was 21.7±7.9 preoperatively and 12.3±8.1 at the first month postoperatively. A total of 59 patients (17.3%) experienced postoperative complications until the first month after the surgery. Among them, 49 patients (14.3%) showed grade I complications, 9 patients (2.6%) showed grade II complications, and 1 patient (0.3%) showed a grade IIIb complication. No patients had complications graded higher than IIIb.
Conclusions: Although the modified CCS is a useful tool for communication among clinicians in allowing comparison of surgical outcomes, this classification should be revised to gain higher accuracy and applicability in the evaluation of postoperative complications of HPS-PVP.
키워드
Complications;Lasers;Prostatic hyperplasia;Transurethral resection of prostate;Transurethral vaporesection of prostate
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