Nadir KALFAZADE, Fatih AKKAŞ, Emre ŞAM, Kamil Gökhan ŞEKER, Ekrem GÜNER, Selçuk ŞAHİN, Volkan TUĞCU

Açık basit prostatektominin seksenliklerde güvenilirlik ve etkinliği: Tek merkez deneyimi

Amaç: Bu çalışma ile 80 yaşından büyük hastalarda açık simple prostatektominin (ASP) güvenilirliğinin ve etkinliğinin araştırılması amaçladı. Gereç ve Yöntemler: Ocak 2012-Ocak 2018 tarihleri arasında merkezimizde ASP uygulanan hastalar bu çalışmanın hedef kitlesini oluşturmuştur. Hastalar, tüm kohort üç yaş grubuna bölünerek değerlendirilmiştir: 50-64, 65-79 ve ≥80. Çalışma grupları demografik özellikler, ameliyat öncesi klinik veriler, operasyonel parametreler, ameliyat sonrası birinci ay ve üçüncü ay üroflowmetrik veriler ve kısa dönem komplikasyon oranları açısından karşılaştırıldı. Bulgular: Ameliyat öncesi dirençli akut üriner retansiyon ve üretral kateterizasyon oranları, ≥80 yaş grubunda olanlarda diğer hasta gruplarına göre anlamlı derecede yüksekti. Gruplar intraoperatif tahmini kan kaybı, kan transfüzyonu, Clavien-Dindo Class≥3 komplikasyon oranları ve genel komplikasyon oranı açısından istatistiksel olarak benzerdi. Karşılaştırmalı analiz, kateterizasyon süresinin Grup 2 ve 3'te Grup 1'e göre anlamlı olarak daha uzun olduğunu gösterdi (p=<0,001). Hastanede kalış süresi de Grup 3’teki hastalarda Grup 1'deki hastalara göre anlamlı olarak daha yüksekti (p=0,003). Sonuç: ASP, ≥80 yaş grubunda olanlarda etkili ve güvenli bir cerrahi tedavi yöntemi olmasına rağmen, işleme bağlı morbidite ve mortalite oranlarını azaltmak için her hasta bireyselleştirilmiş bir yaklaşımla yönetilmelidir.

Anahtar Kelimeler:

Benign prostat hiperplazisi, Açık basit prostatektomi, Seksenlikler

Safety and effectivity of open simple prostatectomy in octogenarians: A single center experience

Objective: This study aimed to investigate the safety and effectiveness of open simple prostatectomy (OSP) in patients older than 80 (i.e., octogenarians). Materials and Methods: Patients who underwent OSP in our center between January 2012 and January 2018 constituted this study's target population. The patients were evaluated by dividing the entire cohort into three age groups: 50-64, 65-79, and ≥80. The study groups were compared regarding demographic features, preoperative clinical data, operative parameters, postoperative first-month and third-month uroflowmetric data, and short-term complication rates. Results: Preoperative persistent acute urinary retention and urethral catheterization rates were significantly higher in octogenarians than in the other patients. The groups were similar concerning intraoperative estimated blood loss, blood transfusion, Clavien-Dindo Class≥3 complication rates and the general complication rate statistically. The comparative analysis revealed that the duration of catheterization was significantly longer in Group 2 and 3 than Group 1 (p=<0.001). The length of hospital stay was also significantly higher in octogenarians than the patients in Group 1 (p=0.003). Conclusion: Although OSP is an effective and safe surgical treatment method in octogenarians, each patient should be managed by an individualized approach for lowering the procedure-related morbidity and mortality rates.

Keywords:

Benign prostatic hyperplasia, Open simple prostatectomy, Octogenarians,

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