Login to Access Video or Poster Abstract: MP02-05
Sources of Funding: None

Introduction

Laser enucleation with morcellation (LEM) has gradually increased in popularity and is increasingly being performed in the United States. This database study compares early operative and post-operative outcomes following laser enucleation and laser photovaporization (LP).

Methods

All patients (2011-2014) that underwent LEM (CPT code 52649) or LP (CPT code 52648) were identified from the National Surgical Quality Improvement (NSQIP) Database. The two groups were compared for demographics, operative times, post-operative complications, readmission and re-operative rates. Data are represented as mean ± standard deviation (SD) or median (interquartile range). Logistic regression analysis was performed to account for confounders and a p value of <0.05 was considered significant.

Results

A total of 8,171 patients were identified. 14.5% (n=1187) had LEM and 84.5% (n=6984) had LP. The respective mean age group was 69.3±8.7 and 71.4±9.2 years in the LEM and LP groups. Race distribution (LEM/LP) was white (1007/5096), Black (71/338) and others (109/1150). The ASA distribution (1/2/3/4) was 47/646/466/28 in LEM and 228/3099/3356/298 in LP groups. The mean BMI was similar for the LEM and LP groups at 28.4 and 27.87, respectively. The number of cases performed during the years 2011, 2012, 2013, and 2014 were 135/291/372/389 in the LEM group and 1045/1562/2056/2321 in the LP group. A higher proportion of patients required general anesthesia ( 93.6% vs 84.3%) and were performed in an inpatient setting( 38.5% vs 17.4%) in LEM vs LP. The mean operative time was significantly longer in the LEM (106.7 vs 54.8 minutes, p=0.001) versus the LP groups. The mean length of stay after surgery was also longer (1.24 vs 0.67 days, p=0.0001) in the LEM group. The differences in the transfusion rates, urinary tract infections, re-operative and readmission rates are shown in Table 1.

Conclusions

Regarding patients undergoing LEM versus LP, a higher proportion of patients require inpatient admission and the operative time is significantly longer in the LEM group compared to the LP group. The transfusion rate is higher for LEM compared to LP, but readmission and re-operative rates are similar. LEM is a feasible and comparatively safe operation to LP.

Funding

None