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Fluoroscopy screening time and radiation dose during complete supine percutaneous nephrolithotomy

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A Letter to the Editor to this article was published on 31 January 2023

Abstract

Purpose

Fluoroscopy-guided percutaneous nephrolithotomy (PCNL) is procedure of choice for treatment of large urinary tract calculi. This study aimed to investigate the affecting factors on fluoroscopy screening time (FST) and radiation dose (RD) of patients undergoing complete supine percutaneous nephrolithotomy (csPCNL).

Methods

Analytic cross-sectional study was performed on 355 patients who underwent csPCNL. The correlation between the FST and RD and patients’ demographics, stone characteristics, preoperative, intraoperative and postoperative parameters were assessed. Multivariate regression analysis was used to explore various parameters which affect FST and RD.

Results

Of all 355 patients, 191 (54.65%) were male and 161 were (45.35%) female with mean age of 48.29 ± 12.38 (16–82) years. BMI was 27.61 ± 4.53 (16.61–39.00) kg/m2. The mean operative time was 45.87 ± 18.29 min with mean FST of 101.72 ± 62.00 s. BMI, operative time, success rate, complications, stone number, and tract number had a significant relationship with FST and RD (P < 0.05). On multivariate analysis, BMI, tract number and success rate were found to be independent predictors for FST and RD. Age, gender, operation side, GFR, target calyx, lithotripsy history, stone opacity, size and site, stone configuration and distribution, and hydronephrosis did not have any correlation with FST and RD (P > 0.05).

Conclusion

BMI, success rate and tract number can be significant predictor for FST and RD during csPCNL. Identifying the affecting factors on FST and RD can help the surgeon to minimize the danger of radiation exposure by predicting and preoperative planning.

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References

  1. Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 69:468–474

    Article  Google Scholar 

  2. Brannen GE, Bush WH, Correa RJ, Gibbons RP, Elder JS (1985) Kidney stone removal: percutaneous versus surgical lithotomy. J Urol 133(1):6–12

    Article  CAS  Google Scholar 

  3. Patel RM, Okhunov Z, Clayman RV, Landman J (2017) Prone versus supine percutaneous nephrolithotomy: what is your position? Curr Urol Rep 18(4):26

    Article  Google Scholar 

  4. Falahatkar S, Moghaddam AA, Salehi M, Nikpour S, Esmaili F, Khaki N (2008) Complete supine percutaneous nephrolithotripsy comparison with the prone standard technique. J Endourol 22(11):2513–2517

    Article  Google Scholar 

  5. Falahatkar S, Mokhtari G, Teimoori M (2016) An update on supine versus prone percutaneous nephrolithotomy: a meta-analysis. Urol J 13(5):2814–2822

    Google Scholar 

  6. Yuan D, Liu Y, Rao H, Cheng T, Sun Z, Wang Y, Liu J, Chen W, Zhong W, Zhu J (2016) Supine versus prone position in percutaneous nephrolithotomy for kidney calculi: a meta-analysis. J Endourol 30(7):754–763

    Article  Google Scholar 

  7. Li J, Gao L, Li Q, Zhang Y, Jiang Q (2019) Supine versus prone position for percutaneous nephrolithotripsy: a meta-analysis of randomized controlled trials. Int J Surg 66:62–71

    Article  Google Scholar 

  8. Falahatkar S, Allahkhah A, Soltanipour S (2011) Supine percutaneous nephrolithotomy: pro. Urol J 8(4):257–264

    Google Scholar 

  9. Majidpour HS (2010) Risk of radiation exposure during PCNL. Urol J 7(2):87–89

    Google Scholar 

  10. Ozbir S, Atalay HA, Canat HL, Culha MG, Cakır SS, Can O, Otunctemur A (2019) Factors affecting fluoroscopy time during percutaneous nephrolithotomy: impact of stone volume distribution in renal collecting system. Int Braz J Urol 45(6):1153–1160

    Article  Google Scholar 

  11. Tepeler A, Binbay M, Yuruk E, Sari E, Kaba M, Muslumanoglu AY, Tefekli A (2009) Factors affecting the fluoroscopic screening time during percutaneous nephrolithotomy. J Endourol 23(11):1825–1829

    Article  Google Scholar 

  12. Balaji SS, Vijayakumar M, Singh AG, Ganpule AP, Sabnis RB, Desai MR (2019) Analysis of factors affecting radiation exposure during percutaneous nephrolithotomy procedures. BJU Int 124(3):514–521

    Article  Google Scholar 

  13. Mancini JG, Raymundo EM, Lipkin M, Zilberman D, Yong D, Banez LL et al (2010) Factors affecting patient radiation exposure during percutaneous nephrolithotomy. J Urol 184:2373–2377

    Article  Google Scholar 

  14. Noureldin YA, Elkoushy MA, Andonian S (2015) Predictors of fluoroscopy time during percutaneous nephrolithotomy: impact of postgraduate urology trainees and S.T.O.N.E. nephrolithometry score. J Endourol 29:542–547

    Article  Google Scholar 

  15. Falahatkar R, Shahraki T, Falahatkar S, Esmaeili S, Mashouf P (2021) Evaluating outcomes of complete supine percutaneous nephrolithotomy for staghorn vs multiple non-staghorn renal stones: a 10-year study. World J Urol 39(8):3071–3077

    Article  CAS  Google Scholar 

  16. Falahatkar S, Esmaeili S, Rastjou Herfeh N, Kazemnezhad E, Falahatkar R, Yeganeh M, Jafari A (2022) The safety of continued low dose aspirin therapy during Complete Supine Percutaneous Nephrolithotomy (csPCNL). Prog Urol 32(6):458–464

    Article  CAS  Google Scholar 

  17. Falahatkar S, Mokhtari G, Amin A, Kazemnezhad E, Esmaeili S, Herfeh NR, Falahatkar R (2017) Comparison of the outcomes of complete supine percutaneous nephrolithotomy in patients with radiopaque and radiolucent kidney stones. Turk J Urol 43(4):490–496

    Article  Google Scholar 

  18. Basiri A, Ziaee SA, Nasseh H, Kamranmanesh M, Masoudy P, Heidary F et al (2008) Totally ultrasonography-guided percutaneous nephrolithotomy in the flank position. J Endourol 22(7):1453–1457

    Article  Google Scholar 

  19. Watterson JD, Soon S, Jana K (2006) Access related complications during percutaneous nephrolithotomy: urology versus radiology at a single academic institution. J Urol 176(1):142–145

    Article  Google Scholar 

  20. Chen TT, Wang C, Ferrandino MN, Scales CD, Yoshizumi TT, Preminger GM, Lipkin ME (2015) Radiation exposure during the evaluation and management of nephrolithiasis. J Urol 194(4):878–885

    Article  Google Scholar 

  21. Kumar P (2008) Radiation safety issues in fluoroscopy during percutaneous nephrolithotomy. Urol J 5(1):15–23

    Google Scholar 

  22. Sfoungaristos S, Gofrit ON, Yutkin V, Landau EH, Pode D, Duvdevani M (2015) Evaluating parameters affecting fluoroscopy time during percutaneous nephrolithotomy: focus on the predictive role of Guy’s, S.T.O.N.E., and CROES scoring systems. J Endourol 29(12):1366–1370

    Article  Google Scholar 

  23. Zampini AM, Bamberger JN, Gupta K, Gallante B, Atallah WM, Gupta M (2021) Factors affecting patient radiation exposure during prone and supine percutaneous nephrolithotomy. J Endourol 35(10):1448–1453

    Article  Google Scholar 

  24. Vollstedt A, Ingimarsson J, Dagrosa L, Pais V (2019) Increasing stone complexity does not affect fluoroscopy time in percutaneous nephrolithotomy. Ther Adv Urol 11:1756287219840218

    Article  CAS  Google Scholar 

  25. Carter HB, Näslund EB, Riehle RA Jr (1987) Variables influencing radiation exposure during extracorporeal shock wave lithotripsy. Review of 298 treatments. Urology 30(6):546–550

    Article  CAS  Google Scholar 

  26. Sourial MW, Todd AM, Palettas MS, Knudsen BE (2019) Reducing fluoroscopy time in percutaneous nephrolithotomy. J Endourol 33(5):369–374

    Article  Google Scholar 

  27. Lipkin ME, Mancini JG, Toncheva G, Wang AJ, Anderson-Evans C, Simmons WN, Ferrandino MN, Yoshizumi TT, Preminger GM (2012) Organ-specific radiation dose rates and effective dose rates during percutaneous nephrolithotomy. J Endourol 26(5):439–443

    Article  Google Scholar 

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Acknowledgements

This study was supported by Urology Research Center, Guilan University of Medical Sciences. In addition, it is adapted from the Specialty thesis of Purya Haghjoo.

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Authors and Affiliations

  1. Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Siavash Falahatkar, Purya Haghjoo, Samaneh Esmaeili & Ehsan Kazemnezhad

Authors
  1. Siavash Falahatkar
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  2. Purya Haghjoo
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  3. Samaneh Esmaeili
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  4. Ehsan Kazemnezhad
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Contributions

SF: project development and manuscript editing. PH: data collection, manuscript writing, and manuscript editing. SE: data management, data analysis, and manuscript writing. EK: data analysis.

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Correspondence to Purya Haghjoo.

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The authors declare that have no conflict of interest for this manuscript and do not have any financial interest.

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The study was retrospective and all personal information of the patients remained confidential. In addition, the principles of trusteeship were fully respected by the researchers.

Research involving human participants and/or animals

Research involving personal data of human participants, and the researchers performed it in compliance with all legal and ethical requirements.

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Falahatkar, S., Haghjoo, P., Esmaeili, S. et al. Fluoroscopy screening time and radiation dose during complete supine percutaneous nephrolithotomy. World J Urol 40, 2601–2607 (2022). https://doi.org/10.1007/s00345-022-04138-5

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  • DOI: https://doi.org/10.1007/s00345-022-04138-5

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