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Proceedings Paper

Tissue ablation after 120W greenlight laser vaporization and bipolar plasma vaporization of the prostate: a comparison using transrectal three-dimensional ultrasound volumetry
Author(s): Benedikt Kranzbühler; Oliver Gross; Christian D. Fankhauser; Lukas J. Hefermehl; Cédric Poyet; Remo Largo; Michael Müntener; Hans-Helge Seifert; Matthias Zimmermann; Tullio Sulser; Alexander Müller; Thomas Hermanns
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Paper Abstract

Introduction and objectives: Greenlight laser vaporization (LV) of the prostate is characterized by simultaneous vaporization and coagulation of prostatic tissue resulting in tissue ablation together with excellent hemostasis during the procedure. It has been reported that bipolar plasma vaporization (BPV) of the prostate might be an alternative for LV. So far, it has not been shown that BPV is as effective as LV in terms of tissue ablation or hemostasis. We performed transrectal three-dimensional ultrasound investigations to compare the efficiency of tissue ablation between LV and BPV. Methods: Between 11.2009 and 5.2011, 50 patients underwent pure BPV in our institution. These patients were matched with regard to the pre-operative prostate volume to 50 LV patients from our existing 3D-volumetry-database. Transrectal 3D ultrasound and planimetric volumetry of the prostate were performed pre-operatively, after catheter removal, 6 weeks and 6 months. Results: Median pre-operative prostate volume was not significantly different between the two groups (45.3ml vs. 45.4ml; p=1.0). After catheter removal, median absolute volume reduction (BPV 12.4ml, LV 6.55ml) as well as relative volume reduction (27.8% vs. 16.4%) were significantly higher in the BPV group (p<0.001). After six weeks (42.9% vs. 33.3%) and six months (47.2% vs. 39.7%), relative volume reduction remained significantly higher in the BPV group (p<0.001). Absolute volume reduction was non-significantly higher in the BPV group after six weeks (18.4ml, 13.8ml; p=0.051) and six months (20.8ml, 18ml; p=0.3). Clinical outcome parameters improved significantly in both groups without relevant differences between the groups. Conclusions: Both vaporization techniques result in efficient tissue ablation with initial prostatic swelling. BPV seems to be superior due to a higher relative volume reduction. This difference had no clinical impact after a follow-up of 6M.

Paper Details

Date Published: 9 February 2012
PDF: 9 pages
Proc. SPIE 8207, Photonic Therapeutics and Diagnostics VIII, 820713 (9 February 2012); doi: 10.1117/12.909294
Show Author Affiliations
Benedikt Kranzbühler, Univ. Hospital Zürich (Switzerland)
Oliver Gross, Univ. Hospital Zürich (Switzerland)
Christian D. Fankhauser, Univ. Hospital Zürich (Switzerland)
Lukas J. Hefermehl, Univ. Hospital Zürich (Switzerland)
Cédric Poyet, Univ. Hospital Zürich (Switzerland)
Remo Largo, Univ. Hospital Zürich (Switzerland)
Michael Müntener, Univ. Hospital Zürich (Switzerland)
Hans-Helge Seifert, Univ. Hospital Zürich (Switzerland)
Matthias Zimmermann, Univ. Hospital Zürich (Switzerland)
Tullio Sulser, Univ. Hospital Zürich (Switzerland)
Alexander Müller, Univ. Hospital Zürich (Switzerland)
Thomas Hermanns, Univ. Hospital Zürich (Switzerland)

Published in SPIE Proceedings Vol. 8207:
Photonic Therapeutics and Diagnostics VIII
Anita Mahadevan-Jansen; Andreas Mandelis; Kenton W. Gregory; Nikiforos Kollias; Hyun Wook Kang; Henry Hirschberg; Melissa J. Suter; Brian Jet-Fei Wong; Justus F. Ilgner; Stephen Lam; Bodo E. Knudsen; Steen Madsen; E. Duco Jansen; Bernard Choi; Guillermo J. Tearney; Laura Marcu; Haishan Zeng; Matthew Brenner; Krzysztof Izdebski, Editor(s)

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