Hein, Simon, Wilhelm, Konrad, Miernik, Arkadiusz, Schoenthaler, Martin, Suarez-Ibarrola, Rodrigo, Gratzke, Christian, Salem, Johannes, Karapanos, Leonidas, Netsch, Christopher, Becker, Benedikt, Secker, Armin, Veser, Julian, Neisius, Andreas, Fritsche, Hans-Martin and Schnabel, Marco Julius . Radiation exposure during retrograde intrarenal surgery (RIRS): a prospective multicenter evaluation. World J. Urol.. NEW YORK: SPRINGER. ISSN 1433-8726

Full text not available from this repository.

Abstract

Purpose Retrograde intrarenal surgery (RIRS) may require extensive X-ray usage. We evaluated the impact of preoperative surgeon briefing regarding the inclusion and evaluation of fluoroscopy time (FT) and dose area product (DAP) in a multicenter study on the applied X-ray usage. Methods A prospective multicenter study of 6 tertiary centers was performed. Each center recruited up to 25 prospective patients with renal stones of any size for RIRS. Prior to study ' s onset, all surgeons were briefed about hazards of radiation and on strategies to avoid high doses in RIRS. Prospective procedures were compared to past procedures, as baseline data. FT was defined as the primary outcome. Secondary parameters were stone-free rate (SFR), complications according to the Clavien, SATAVA and postureteroscopic lesion scale. Results were analyzed usingTtest, chi-squared test, univariate analysis and confirmed in a multivariate regression model. Results 303 patients were included (145 retro- and 158 prospective). Mean FT and DAP were reduced from 130.8 s/565.8 to 77.4 s/357.8 (p < 0.05). SFR was improved from 85.5% to 93% (p < 0.05). Complications did not vary significantly. Neither stone position (p = 0.569), prestenting (p = 0.419), nor surgeons' experience (> 100 RIRS) had a significant impact on FT. Significant univariate parameters were confirmed in a multivariate model, revealing X-ray training to be radiation protective (OR - 44,p = 0.001). Conclusions Increased surgeon awareness of X-ray exposure risks has a significant impact on FT and DAP. This awareness effect is a simple method to reduce radiation exposure for the patient and OR staff without the procedures ' outcome and safety being affected.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hein, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wilhelm, KonradUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miernik, ArkadiuszUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schoenthaler, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Suarez-Ibarrola, RodrigoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gratzke, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salem, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karapanos, LeonidasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Netsch, ChristopherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Becker, BenediktUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Secker, ArminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Veser, JulianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neisius, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fritsche, Hans-MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnabel, Marco JuliusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-340478
DOI: 10.1007/s00345-020-03160-9
Journal or Publication Title: World J. Urol.
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1433-8726
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
FLUOROSCOPY TIME; URETEROSCOPIC TREATMENT; FLEXIBLE URETEROSCOPY; COMPLICATIONS; MANAGEMENT; CATEGORIZATIONMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34047

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item