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RÉSUMÉ
Introduction. L’énucléation de la prostate au laser Holmium (HoLEP) est recommandée comme une alternative à la résection endoscopique de la prostate (RTUP) ou à l’adénomectomie par voie sus-pubienne. L’objectif général de cette étude était d’examiner la faisabilité de l’HoLEP en chirurgie ambulatoire dans le service d’Urologie-Andrologie de l’Hôpital Jacques Monod au Havre. Méthodologie. Il s’agissait d’une étude rétrospective de type descriptif à visée analytique ayant porté sur les patients pris en charge par HoLEP entre le 01er février 2018 et le 25 juin 2023. Les caractéristiques pré, per, postopératoires et les complications postopératoires des patients ont été analysées. Une analyse en uni variée des facteurs de risque ainsi que la distribution de ces facteurs de risque avait été effectuée. Résultats. Nous avons étudié 151 patients. L’âge moyen des patients était de 74 ans ±8,2. Les comorbidités étaient présentes chez 78,15% des patients. En préopératoire le volume de la prostate estimé était en moyen de 79,01 ±29,3cc. Le score ASA2 était le plus fréquent soit 47,68%. Tous les patients ont été opérés sous anesthésie générale. La durée opératoire moyenne était de 125,2 ±46,63 minutes. La durée moyenne du cathétérisme vésical postopératoire était de 42,46 ±20,07 heures. Trente cinq patients ont présenté au moins une complication post-opératoires et l’hématurie était la complication la plus fréquente(n=20) soit 57,14%. Nous avons enregistré 4 cas de transfusion post-opératoire soit 2,64%. Les 151 patients ont été opérés par 7 chirurgiens. Le plus expérimenté a effectuée 54 procédures soit 35,76%. La plupart des complications post-opératoires étaient de grade II selon la classification de Clavien-Dindo soit 88,53%. Conclusion. L’expérience du chirurgien au-delà de 50 cas est un atout majeur pour minimiser les risques de survenue de complications postopératoires. Il est nécessaire de mener d’autres études prospectives tout en élargissant l’échantillon, afin de mieux cerner les facteurs prédictifs.
ABSTRACT
Introduction. Holmium laser enucleation of the prostate (HoLEP) is recommended as an alternative to endoscopic resection of the prostate (TURP) or suprapubic adenomectomy. The general objective of this study was to examine the feasibility of HoLEP in outpatient surgery in the Urology-Andrology Department of the Jacques Monod Hospital in Le Havre. Methodology. This was a retrospective descriptive study of patients managed by HoLEP between 01 February 2018 and 25 June 2023. Pre-, intra- and post-operative characteristics and post-operative complications were analysed. A univariate analysis of risk factors and their distribution was performed. Results. We studied 151 patients. The mean age of the patients was 74 ±8.2 years. Comorbidities were present in 78.15% of patients. Preoperative prostate volume was estimated to be 79.01 ±29.3cc on average. The ASA2 score was the most frequent (47.68%). All patients underwent surgery under general anaesthesia. The average operating time wa s 125.2 ±46.63 minutes. The mean duration of postoperative bladder catheterisation was 42.46 ±20.07 hours. Thirty-five patients had at least one post-operative complication, and haematuria was the most frequent complication (n=20), i.e. 57.14%. We recorded 4 cases of postoperative transfusion (2.64%). The 151 patients were operated on by 7 surgeons. The most experienced performed 54 procedures (35.76%). Most of the postoperative complications were grade II according to the Clavien-Dindo classification, i.e. 88.53%. Conclusion. The surgeon's experience beyond 50 cases is a major asset in minimising the risk of postoperative complications. Further prospective studies, with a larger sample size, are needed to better identify the predictive factors.

Keywords

HoLEP Surgery Outpatient BPH Jacques Monod HoLEP Chirurgie ambulatoire HBP Jacques Monod

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Barry MD, Diallo AB, Bah I, Kante D, Bah MB, Diallo A, Barry MM, Soudani M, Barry AO, & Bah OR. (2024). Feasibility of Holmium Laser Enucleation of the Prostate (HoLEP) on an outpatient basis at Le Havre (France) : A Retrospective Study: Faisabilité de l’Énucléation de la Prostate au Laser Holmium (HoLEP) en Ambulatoire au Havre (France) : Une Étude Rétrospective. HEALTH SCIENCES AND DISEASE, 25(11). https://doi.org/10.5281/hsd.v25i11.6146
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