Factors Affecting the Fluoroscopic Screening Time During Percutaneous Nephrolithotomy

Tepeler, Abdülkadir; Binbay, Murat; Yürük, Emrah; Sarı, Esin Söğütlü; Kaba, Mehmet; Müslümanoğlu, Ahmet Yaser; Tefekli̇, Ahmet

doi:10.1089/end.2009.0256

Cited by 63 publications

(48 citation statements)

References 27 publications

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“…The median BMI of our study population is within the reported range in our geographic area 23 and is comparable to similar PCNL studies reporting BMI. 15,19,20,24 The mean fluoroscopy time in our study cohort was only 3.4 minutes, which is shorter than most case series using standard PCNL techniques (Table 4), and the mean effective dose of 2.4 mSv in our cohort compares favourably to published reports. For standard PCNL using contrast pyelography, Lipkin and colleagues 24 reported a mean fluoroscopy time about 3 times the amount in our study cohort.…”

Section: Tion Exceed the International Commission On Radiologicalsupporting

confidence: 64%

“…18 Increased radiation exposure during PCNL has been correlated with high BMI, larger stone burden, longer operative times and surgeon inexperience. [19][20][21] In our study, longer fluoroscopy time correlated with increased stone size (p < 0.01), longer operative time (p < 0.01) and lower treatment success rates (p < 0.01); these factors may be considered surrogate markers of the degree of surgical difficulty. However, higher effective dose, a more accurate measure of biologically significant radiation exposure than fluoroscopy time alone, 16,22 correlated only with increased skin-to-stone distance (p < 0.01); interestingly, we did not find any correlation between BMI and ePCNL-related fluoroscopy time, effective dose or operative time as commonly reported in other studies involving standard PCNL techniques.…”

Section: Tion Exceed the International Commission On Radiologicalmentioning

confidence: 51%

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Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy

Lantz

O’Malley

Ordon

et al. 2014

CUAJ

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Introduction: Percutaneous nephrolithotomy (PCNL) may be associated with significant ionizing radiation exposure for patients and operating room staff. Endoscopic-guided PCNL (ePCNL) is a technique that may be associated with less radiation exposure. This study examines ePCNL-related radiation exposure (fluoroscopy time, effective dose) and investigates variables that may predict increased exposure. Methods: A retrospective review of all consecutive ePCNLs performed at our institution, by a single surgeon, was conducted between November 2011 and November 2013. Patient demographics, stone characteristics and perioperative details were recorded, including radiation exposure. Pearson and Spearman correlation were used to assess variables correlated with radiation exposure. Results: In total, 55 ePCNL cases were included in the study. The mean age was 60 ± 15 years, mean body mass index (BMI) 30.0 ± 6.4 kg/m 2 and mean stone size 3.2 × 2.1 cm. Seven cases (13%) involved complete staghorn stones, and 69% involved supracostal punctures. The mean fluoroscopy time was 3.4 ± 2.3 minutes, mean ED 2.4 ± 1.9 mSv. The treatment success rate, assessed 1-week postoperatively, was 87.3% and 7.3% of cases required ancillary procedures. The overall complication rate was 29%, but only 3 cases (5.5%) were Clavien ≥3. Longer fluoroscopy time correlated with increased stone size (p < 0.01), longer operative time (p < 0.01) and lower treatment success rates (p < 0.01); higher effective dose correlated with longer fluoroscopy time (p < 0.01) and increased skin-to-stone distance (p < 0.01). BMI did not correlate with fluoroscopy time or effective dose. Conclusions: Outcomes of ePCNL are comparable to traditional PCNL techniques and may be associated with lower radiation exposure, particularly beneficial for patients with higher BMI.

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Section: Tion Exceed the International Commission On Radiologicalsupporting

confidence: 64%

Section: Tion Exceed the International Commission On Radiologicalmentioning

confidence: 51%

Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy

Lantz

O’Malley

Ordon

et al. 2014

CUAJ

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“…They reported a mean of 10.19±0.3 minutes of screening. They revealed stone size and number of accesses were important factors for fluoroscopy time (11). This seems higher than our fluoroscopy times but they have higher stone burden than our cohort.…”

Section: Discussioncontrasting

confidence: 49%

Comparison of Pneumatic, Ultrasonic and Combination Lithotripters in Percutaneous Nephrolithotripsy

Zengın

Şener

Baş³

et al. 2014

Int. braz j urol.

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“…After the insertion of a ureteral catheter in the lithotomy position, access to the posterior calyceal calyx was achieved intraoperatively with the aid of C-arm fluoroscopy using an 18-gauge access needle with the patient in the prone position as previously described [8]. Tract dilation was accomplished using a high-pressure balloon dilator (Nephromax™; Boston Scientific) (n = 79) or Amplatz dilators (n = 65′′).…”

Section: Methodsmentioning

confidence: 99%

Parenchymal Thickness: Does It Have an Impact on Outcomes of Percutaneous Nephrolithotomy?

et al. 2013

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Objective: To evaluate whether renal parenchymal thickness (RPT) has an effect on the outcomes of percutaneous nephrolithotomy (PNL). Methods: We performed a retrospective analysis of 144 patients with lower pole and/or renal pelvic stones who underwent PNL. The relationship between RPT and peri- and postoperative measures was evaluated. Results: The average age was 45.94 ± 14.47 (15-76) years. The mean BMI was calculated as 27.47 ± 4.73 (16.9-44.9) kg/m². The mean stone burden was 293 ± 126 (150-800 mm²). The mean RPT was measured as 17.33 ± 5.32 (6-35) mm. No correlation was detected between the RPT and the operation or fluoroscopy times or the duration of hospitalization (p = 0.63, 0.52, 0.08, respectively). The mean drop in hemoglobin level was 1.45 ± 1.25 (0-9) g/dl. A negative correlation was detected between hemoglobin drop and RPT (p = 0.01, r = -0.23). However, the RPT was similar in patients who did or did not require a blood transfusion (p = 0.09). The RPT was found to have no impact on success rate (p = 0.4). Conclusion: The postoperative hemoglobin drop increases in parallel with the increase in RPT. However, no relationship was detected between the RPT and blood transfusion, overall success rate or any other perioperative parameters.

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Factors Affecting the Fluoroscopic Screening Time During Percutaneous Nephrolithotomy

Cited by 63 publications

References 27 publications

Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy

Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy

Comparison of Pneumatic, Ultrasonic and Combination Lithotripters in Percutaneous Nephrolithotripsy

Parenchymal Thickness: Does It Have an Impact on Outcomes of Percutaneous Nephrolithotomy?

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