Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy.
Int Urol Nephrol. 2013 Aug;45(4):951-9. doi: 10.1007/s11255-013-0476-1. Epub 2013 May 31.
A modified version of the Clavien system has been recently suggested to allow a standardized assessment of complications associated with transurethral resection of the prostate (TURP). Aim of this multicentre study was to validate the use of this assessment tool in a contemporary cohort of patients undergoing monopolar or bipolar TURP.
Consecutive patients undergoing TURP in five Italian institutions from April 2011 to March 2012 were prospectively included in this study. Complications occurring within first postoperative month were recorded and graded according to the modified Clavien system. Univariate and binary logistic regression analysis were used for statistical analysis.
Two hundred and ninety-five patients were included in the study. Overall, 47 complications were recorded in 44 patients. There was no difference in terms of postoperative complications between those who underwent monopolar TURP (27 pts; 9.2 %) versus those who underwent bipolar TURP (17 pts; 5.2 %, p = 0.142). Overall perioperative morbidity rate was 15.5 %. Most of the complications were Clavien type I (37 cases; 78 %) and II (6 cases; 12 %). High-grade complications were few as follows: Clavien type IIIb in two cases (4 %) and IV in two cases (4 %). No TURP-related deaths were reported. In the monopolar TURP group, a longer-operative time (OR 1.024; 95 % CI 1.007-1.040, p = 0.004) is an independent predictors of postoperative complications.
A modified Clavien system can be considered a practical and easily applicable tool in grading postoperative complications in patients undergoing TURP. Our findings confirm that TURP is a safe procedure associated with minimal perioperative morbidity.
最近提出了一种改良的 Clavien 系统，以允许对经尿道前列腺切除术（TURP）相关并发症进行标准化评估。本多中心研究的目的是在接受单极或双极 TURP 的当代患者队列中验证该评估工具的使用。
本研究前瞻性纳入 2011 年 4 月至 2012 年 3 月在意大利五家机构接受 TURP 的连续患者。记录术后第一个月内发生的并发症，并根据改良的 Clavien 系统进行分级。使用单变量和二项逻辑回归分析进行统计分析。
本研究共纳入 295 例患者。共有 44 例患者发生 47 例并发症。单极 TURP 组（27 例；9.2%）与双极 TURP 组（17 例；5.2%，p=0.142）术后并发症无差异。总体围手术期发病率为 15.5%。大多数并发症为 Clavien Ⅰ型（37 例；78%）和Ⅱ型（6 例；12%）。高等级并发症较少，包括 2 例 Clavien Ⅲb 型和 2 例 Clavien Ⅳ型。无 TURP 相关死亡报告。在单极 TURP 组中，手术时间较长（OR 1.024；95%CI 1.007-1.040，p=0.004）是术后并发症的独立预测因素。
改良的 Clavien 系统可被视为一种实用且易于应用的工具，可用于对接受 TURP 的患者进行术后并发症分级。我们的发现证实 TURP 是一种安全的手术，围手术期发病率低。
