2176 MID-TERM OUTCOMES OF GREENLIGHT VAPOR-INCISION OF THE PROSTATE (VIT): COMPARISON OF OUTCOMES TO STANDARD GREENLIGHT 120W HPS VAPORIZATION IN PROSTATE VOLUMES GREATER THAN 80CC
Bibliographic record
Abstract
You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology III1 Apr 20122176 MID-TERM OUTCOMES OF GREENLIGHT VAPOR-INCISION OF THE PROSTATE (VIT): COMPARISON OF OUTCOMES TO STANDARD GREENLIGHT 120W HPS VAPORIZATION IN PROSTATE VOLUMES GREATER THAN 80CC Kevin Zorn, Gagan Gautam, Dan Liberman, Tal Ben-Zvi, Pierre-Allain Hueber, and Tom Deklaj Kevin ZornKevin Zorn Montreal, Canada More articles by this author , Gagan GautamGagan Gautam Chicago, IL More articles by this author , Dan LibermanDan Liberman Montreal, Canada More articles by this author , Tal Ben-ZviTal Ben-Zvi Montreal, Canada More articles by this author , Pierre-Allain HueberPierre-Allain Hueber Montreal, Canada More articles by this author , and Tom DeklajTom Deklaj Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2349AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The most common technique of photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) involves centripetal tissue vaporization only. With less effective energy delivery over time (fiber degradation), poor surgical capsule (endpoint) discrimination while vaporizing and suboptimal effectiveness of Greenlight 120W-HPS in larger prostates, we sought to reproduce the principles of prostate enucleation and evaluate a hybrid technique (vapor-incision technique (VIT)) in glands >80cc. METHODS VIT was performed in 55 consecutive men with a prostate >80cc by a single surgeon (KCZ) between May-Dec 2010. G-LEP involved adenoma incision at 5 and 7-oclock positions followed by 3,9 and 12 o'clock incisions down to the surgical capsule. Side-fire vaporization along the capsule was carried out thereby detaching TURP-like tissue strips for retrieval. Functional followup included IPSS, Quality of Life (QoL), serum PSA, maximum flow rate (Qmax), post void residual (PVR) determinations and volumetric measurements with transrectal ultrasonography (TRUS). Functional evaluations were performed at 1, 3, 6 and 12 months. Outcomes were compared to a sizematched-cohort of 50 men who previously underwent vaporization-only PVP. Change in baseline outcomes and complication rates were retrospectively assessed. RESULTS Mean age, PSA and prostate size for the VIT and control PVP cohorts were 69vs67yrs, 5.1vs4.9ng/mL and 89vs92g, respectively (all p>0.05). Mean laser time, operative time and energy usage were 38vs53min; 67 vs 88min; and 229 vs 345kJ, respectively (p<0.05 for all). At 12 months, mean IPSS improved 69%vs54%, Qmax increased by 221%vs164% and PVR decreased by 89%vs73%, respectively (p<0.05 for all). Mean VIT extracted tissue weight was 27.2g(range 19-52). Mean decrease in pre-operative PSA at 12 months was 73%vs52% (p<0.01), respectively. Hospital stay, catheterization time and complication rates were comparable between groups. CONCLUSIONS While both cohorts demonstrated significant improvements in baseline voiding parameters, short-term analysis demonstrates that VIT provides superior short-term outcomes to standard HPS-PVP in men with prostate volumes >80cc. G-LEP also appears to be more time-efficient, consumes less energy and obtains tissue for pathological evaluation. Further follow-up is required to assess the durability of VIT to PVP vaporization only for large prostate glands. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e877-e878 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Zorn Montreal, Canada More articles by this author Gagan Gautam Chicago, IL More articles by this author Dan Liberman Montreal, Canada More articles by this author Tal Ben-Zvi Montreal, Canada More articles by this author Pierre-Allain Hueber Montreal, Canada More articles by this author Tom Deklaj Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".