Русский
The role of systematization of postoperative complications in assessing the efficiency and safety of surgical methods for the treatment of benign prostatic hyperplasia
DOI: https://dx.doi.org/10.18565/urology.2022.3.83-91
Sh.I. Giyasov, R.R. Gafarov, Z.R.Shodmonova, Sh.T. Mukhtarov, F.A. Akilov
1) State Institution “Republican Specialized Scientific and Practical Medical Center of Urology”, Tashkent, Uzbekistan; 2) Tashkent Medical Academy, Tashkent, Uzbekistan; 3) Samarkand State Medical University, Samarkand, Uzbekistan
Aim. Adaptation of the Clavien-Dindo classification to the assessment of postoperative complications of surgical treatment of benign prostatic hyperplasia (BPH) and assessment of the efficacy and safety of various surgical methods for treating BPH by systematizing postoperative complications.
Materials and methods. Patients with BPH were divided into three groups depending on the method of surgical treatment. In group I (n=40; 26.7%) HoLEP was performed, while in group II (n=50; 33.3%) and III (n=60; 40%) TURP and open transvesical simple prostatectomy (SP) were done. The Clavien-Dindo classification system was used to adapt to the assessment of postoperative complications of surgical treatment of BPH.
Results. To determine the normal and complicated postoperative period, the respective were developed. According to the adapted Clavien- Dindo classification, postoperative complications were systematized. In group I, there were 28 (70%) complications, including 8 of I grade (28.6%), 16 of II grade (57.1%), 3 of IIIa grade (10.7%) and 1 of IIIb grade (3.6%). There were no complications of IVa, IVb and V grade. In group II, a total of 41 (82.0%) complications were observed, including 16 (39%), 17 (41.5%), 1 (2.4%) and 7 (17.1%) of grade I, II, IIIa and IIIb, respectively. There were also no complications of IVa, IVb and V grade. In group III there were 154 complications in total and 89 (57.8%), 48 (31.2%), 9 (5.8%), 3 (1.96%), 3 (1.96%), 0 and 2 (1.3%) of grade I, II, IIIa, IIIb, IV and V, respectively.
Conclusions. To objectively assess the quality of surgical procedures and systematize complications using the Clavien-Dindo classification, it needs to be adapted, taking into account the specifics of the methods and the postoperative period. OP is characterized as an effective method of eliminating bladder outlet obstruction, but it is associated with significantly longer lengths of stay compared to TURP and HoLEP, more severe complications, and significantly more often requires additional interventions. In terms of morbidity, blood transfusion rate and the length of hospital stay, the results of TURP are comparable to HoLEP, but TURP is inferior in terms of the frequency of long-term complications.
Materials and methods. Patients with BPH were divided into three groups depending on the method of surgical treatment. In group I (n=40; 26.7%) HoLEP was performed, while in group II (n=50; 33.3%) and III (n=60; 40%) TURP and open transvesical simple prostatectomy (SP) were done. The Clavien-Dindo classification system was used to adapt to the assessment of postoperative complications of surgical treatment of BPH.
Results. To determine the normal and complicated postoperative period, the respective were developed. According to the adapted Clavien- Dindo classification, postoperative complications were systematized. In group I, there were 28 (70%) complications, including 8 of I grade (28.6%), 16 of II grade (57.1%), 3 of IIIa grade (10.7%) and 1 of IIIb grade (3.6%). There were no complications of IVa, IVb and V grade. In group II, a total of 41 (82.0%) complications were observed, including 16 (39%), 17 (41.5%), 1 (2.4%) and 7 (17.1%) of grade I, II, IIIa and IIIb, respectively. There were also no complications of IVa, IVb and V grade. In group III there were 154 complications in total and 89 (57.8%), 48 (31.2%), 9 (5.8%), 3 (1.96%), 3 (1.96%), 0 and 2 (1.3%) of grade I, II, IIIa, IIIb, IV and V, respectively.
Conclusions. To objectively assess the quality of surgical procedures and systematize complications using the Clavien-Dindo classification, it needs to be adapted, taking into account the specifics of the methods and the postoperative period. OP is characterized as an effective method of eliminating bladder outlet obstruction, but it is associated with significantly longer lengths of stay compared to TURP and HoLEP, more severe complications, and significantly more often requires additional interventions. In terms of morbidity, blood transfusion rate and the length of hospital stay, the results of TURP are comparable to HoLEP, but TURP is inferior in terms of the frequency of long-term complications.
About the Autors
Corresponding author: R.R. Gafarov – assistant at the Department of Urology Samarkand State Medical University, Samarkand, Uzbekistan; e-mail: rushen.gafarov@bk.ru
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