Learning Curve For Transurethral Plasmakinetic Resection Of The Prostate

Objective:To define a learning curve for transurethral plasmakinetic resection of the prostate (PKRP)Methods:Retrospective analyse the clinical records of60consecutive patients who were selected for transurethral plasmakinetic resection of the prostate between2011.5-2012.8by a single surgeon with no experience for this procedure. The patients were divided into3groups (group A, B, C) and n-20in each group.according to the sequence of the operations. Peri-operative parameters, operation time, blood loss of each subgroups were analysed.Results:All the60patients underwent PKRP successfully. There were significant differences in the median operation time between group A (105.4±39.6min) and group B (79.3±28.9min), group C(71.1±26.8min), but there was no significant difference between group B and group C. There were significant differences in the fall in serum sodium between group A (6.3±1.3mmol/1) and group B (5.1±1.0mmol/1), group C(4.9±1.1mmol/1),but group B and group C did not differ. There were significant differences in blood loss between group A (187±81ml) and group B (147±67ml), group C (133±54ml), but group B and group C did not differ. The three subgroups all differed in IPSS, QOL, Qmax, PRV before and after operation3months. There was no significant difference in IPSS, QOL, Qmax, PRV, age, hemoglobin and serum sodium levels before operation, length of stay, indwelling time of aurethral catheter and the weight of resected prostate tissue between all subgroups.Conclusion:PKRP is a well procedure and of great value in clinical application. This study of the learning curve of a single surgeon suggests that competence at performing PKRP is reached after approximately20cases.