Radiation exposure to the patient and operating room personnel during percutaneous nephrolithotomy

Kumari, G.L.; Kumar, Pratik; Wadhwa, Pankaj; Aron, Monish; Gupta, Narmada P.; Dogra, Prem Nath

doi:10.1007/s11255-005-4972-9

Cited by 87 publications

(50 citation statements)

References 11 publications

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“…However, both the patients and the theater staff have to be prepared for multiple tract percutaneous surgery with its specific characteristics, such as prolonged fluoroscopy and operative time, considerably increased the risk for complications such as bleeding and pleural injury [10]. In addition, radiation exposure during a PCNL is about 0.28 mSv for the urologist on average and the maximum yearly whole-body exposure as recommended by the National Commission on Radiation Protection is 5 rem [11,12]. However, due to the great number of patients, the urologist in our department can easily exceed that limit by accumulative doses.…”

Section: Discussionmentioning

confidence: 99%

Single-Stage Multiple-Tract Percutaneous Nephrolithotomy in the Treatment of Staghorn Stones under Total Ultrasonography Guidance

Fei

Song

et al. 2014

Urol Int

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Objective: To evaluate the safety and efficacy of single-stage multiple-tract percutaneous nephrolithotomy (PCNL) in the treatment of staghorn stones solely guided by ultrasonography (US). Patients and Methods: From May 2007 to July 2012, 55 single-stage multiple-tract PCNL procedures were performed (53 patients, of whom 2 had bilateral stones). Caliceal puncture and dilatation were performed under US guidance in all cases. The procedure was evaluated for access success, length of postoperative hospital stay, complications (modified Clavien system), and stone clearance. Results: The mean (±SD) operating time was 84.87 ± 24.9 min, with a mean (±SD) postoperative hospital stay of 5.2 ± 1.31 days. The patients experienced a mean (±SD) decrease in hemoglobin level of 8.23 ± 2.39 g/l and the stone-free rate after single-stage surgery was 78.18%. Extracorporeal shock wave lithotripsy was indicated in 2 cases as an auxiliary treatment. There were 10 grade 1 (62.5%) and 6 grade 2 (37.5%) complications; however, there were no complications above grade 3. Conclusion: Total US-guided single-stage multiple-tract PCNL for treating staghorn calculi in selected cases is safe, feasible, and may be performed with an acceptable morbidity and with the advantage of preventing radiation hazards and damage to adjacent organs.

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Section: Discussionmentioning

confidence: 99%

Single-Stage Multiple-Tract Percutaneous Nephrolithotomy in the Treatment of Staghorn Stones under Total Ultrasonography Guidance

Fei

Song

et al. 2014

Urol Int

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“…Kumari and colleagues reported that the mean fluoroscopy screening time during the procedure was 6.04 minutes (range, 1.8-12.16 minutes), which compares favorably with that reported in literature. 15 Bowsher et al reported that a 30% reduction in the dose limits is probable. Wearing routine radiation badges under a lead apron is an inadequate method of monitoring exposure: urologists should press for more active assistance from radiation protection officers in the monitoring of procedures in theater and the use of ultrasound should be encouraged.…”

Section: Technical Difficultymentioning

confidence: 99%

What Is the Difference Between Percutaneous Nephrolithotomy in Patients with and without Previous Open Renal Surgery?

Falahatkar

Panahandeh

Ashoori

et al. 2009

Journal of Endourology

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“…Knowledge concerning rate of complications may decrease with the use of smaller instruments is well established, but there is no conclusive evidence about the long-term effect of PNL, even the mini-PNL and micro-PNL on growing kidney in children. There is a need for new studies such as investigating the effect of PNL on growing kidneys [14,15,28,29]. We did not perform PNL routinely in the infants in our series; it was only performed in two patients who initially received percutaneous nephrostomy.…”

Section: Discussionmentioning

confidence: 99%

Management of stone disease in infants

Azılı

Öztürk

İnözü³

et al. 2015

Urolithiasis

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Evaluating and treating renal stone disease in infants are technically challenging. In this study, we evaluated the surgical treatment of renal stones in children under 1 year of age. We retrospectively reviewed the records of patients under 1 year old who were treated with ESWL, endourological or open surgical procedures for renal stone disease between January, 2009 and December, 2012. The patients' age, gender, stone size, stone location and number, complications, stone-free status, and postoperative complications were recorded. 19 of 121 infants with a mean age of 10.2 ± 3.07 months were treated with surgical procedures. Six (75%) of eight cystinuria patients required a surgical intervention. Retrograde endoscopic management was performed in thirteen patients (63.4%) as an initial surgical approach. There were three major (15.7%) complications. The rate of open surgical procedures was 31.6% (6 of 19 infants). The cutoff value of stone size for open surgery was 10 mm. There was a significant relationship between the conversion to open procedures and stone size, stone location, and symptom presentation especially the presence of obstruction (p < 0.05). After repeated treatments, the stone clearance rate of RIRS reached 84.6%. Retrograde intrarenal surgery is an effective and safe treatment method for renal stones in infants and can be used as a first-line therapy in most patients under 1 year old. This is especially important if an associated ureteral stone or lower pole stone that requires treatment is present and for patients with cystinuria, which does not respond favorably to ESWL.

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Radiation exposure to the patient and operating room personnel during percutaneous nephrolithotomy

Abstract: The various operating room personnel are within safe radiation dose limits during PCNL. Efficient fluoroscopy further reduces the radiation scatter. All occupational personnel should 'achieve as low as reasonably achievable' dose by adhering to good practices.

Cited by 87 publications

References 11 publications

Single-Stage Multiple-Tract Percutaneous Nephrolithotomy in the Treatment of Staghorn Stones under Total Ultrasonography Guidance

Single-Stage Multiple-Tract Percutaneous Nephrolithotomy in the Treatment of Staghorn Stones under Total Ultrasonography Guidance

What Is the Difference Between Percutaneous Nephrolithotomy in Patients with and without Previous Open Renal Surgery?

Management of stone disease in infants

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