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Radiation Exposure During Retrograde Intrarenal Surgery (RIRS): a Prospective Multicenter Evaluation
Simon Hein
Konrad Wilhelm
Arkadiusz Miernik
Martin Schönthaler
Rodrigo Suarez-Ibarrola
Christian Gratzke
Johannes Salem
Leonidas Karapanos
Christopher Netsch
Benedikt Becker
Armin Josef Secker
Julian Veser
Andreas Neisius
Hans-Martin Fritsche
Marco Julius Schnabel
出版
Universität
, 2021
URL
http://books.google.com.hk/books?id=E1dwzgEACAAJ&hl=&source=gbs_api
註釋
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 using T test, 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).brbrConclusions