Reduced Radiation Exposure with the Use of an Air Retrograde Pyelogram During Fluoroscopic Access for Percutaneous Nephrolithotomy

2011 ◽  
Vol 25 (4) ◽  
pp. 563-567 ◽  
Author(s):  
Michael E. Lipkin ◽  
John G. Mancini ◽  
Dorit E. Zilberman ◽  
Maria E. Raymundo ◽  
Daniel Yong ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Percutaneous Nephrolithotomy ◽  
Retrograde Pyelogram

1583 REDUCED RADIATION EXPOSURE WITH THE USE OF AN AIR RETROGRADE PYELOGRAM DURING FLUOROSCOPIC ACCESS FOR PERCUTANEOUS NEPHROLITHOTOMY

2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Michael Lipkin ◽  
John Mancini ◽  
Dorit Zilberman ◽  
Eliza Raymundo ◽  
Daniel Yong ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Percutaneous Nephrolithotomy ◽  
Retrograde Pyelogram

FACTORS AFFECTING PATIENT RADIATION EXPOSURE DURING PRONE AND SUPINE PERCUTANEOUS NEPHROLITHOTOMY

2021 ◽  
Author(s):  
Anna M Zampini ◽  
Jacob N Bamberger ◽  
Kasmira R Gupta ◽  
Blair Gallante ◽  
William Atallah ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Percutaneous Nephrolithotomy ◽  
Factors Affecting ◽  
Patient Radiation Exposure

scholarly journals Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy

2014 ◽  
Vol 8 (9-10) ◽  
pp. 347 ◽  
Author(s):  
Andrea G Lantz ◽  
Padraic O'Malley ◽  
Michael Ordon ◽  
Jason Y Lee
Keyword(s):  
Radiation Exposure ◽  
Effective Dose ◽  
Percutaneous Nephrolithotomy ◽  
Treatment Success ◽  
Fluoroscopy Time ◽  
Success Rates ◽  
Stone Size ◽  
Lower Treatment ◽  
The Mean ◽  
Stone Characteristics

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 (fluoroscopytime, 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/m2 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.

scholarly journals Ultrasound Guidance to Assist Percutaneous Nephrolithotomy Reduces Radiation Exposure in Obese Patients

Urology ◽  
2016 ◽  
Vol 98 ◽  
pp. 32-38 ◽  
Author(s):  
Manint Usawachintachit ◽  
Selma Masic ◽  
Helena C. Chang ◽  
Isabel E. Allen ◽  
Thomas Chi
Keyword(s):  
Radiation Exposure ◽  
Percutaneous Nephrolithotomy ◽  
Ultrasound Guidance ◽  
Obese Patients

scholarly journals Safety and Viability of Totally Tubeless Ambulatory Percutaneous Nephrolithotomy (APCNL) in the Fast Paced World

2018 ◽  
Vol 11 (1) ◽  
pp. 14-21
Author(s):  
BM Zeeshan Hameed ◽  
Arun Chawla ◽  
Padmaraj Hegde ◽  
Avinash Odugoudar ◽  
Tirth Vasa
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Endoscopic Management ◽  
Safe Procedure ◽  
Early Recovery ◽  
Early Return ◽  
Skin Infiltration ◽  
Retrograde Pyelogram ◽  
Dj Stent

Background: Percutaneous Nephrolithotomy (PCNL) is the gold standard for endoscopic management of large renal stones. Various modifications have been done to bring down the morbidity of this procedure. Ambulatory PCNL (APCNL) defines PCNL as day-care procedure, avoiding overnight hospital stay which is less than 24 hours. Totally tubeless makes faster recovery without the need for double J stent or nephrostomy tubes. This study aimed at exploring the feasibility and safety of APCNL in selective patients. It also aimed at improvising the procedure to facilitate early recovery and discharge of patients within 24 hrs. Materials ands Methods: In this study, 12 patients underwent APCNL under general anaesthesia with endotracheal intubation from April 2016 to March 2017. All the procedures were done by a single surgeon. The inclusion criteria were stone size of less than 2cm, without any co-morbidities, Computed Tomography (CT)/Retrograde Pyelogram(RGP) evidence of normal pyelocalyceal anatomy, patient staying within the radius of 15km, well informed patient. All patients underwent totally tubeless PCNL i.e. without nephrostomy, DJ stent and catheter. Skin infiltration was given with 0.25% Bupivacaine. Post operatively analgesia was given on demand (intramuscular Aceclofenac / oral Acetaminophen plus Tramadol). All patients were followed up after 2 weeks. Results: Twelve patients underwent prone PCNL. All patients had single puncture (10 lower calyx, 2 middle calyx), Amplatz size was less than 30F, size of the stone (1.3cm to 2cm) with a mean size- 1.7cm, saline used around 300ml. But, two patients were discharged after 36hrs and 48hrs due to pain. None of them returned to hospital with haematuria, pain or urinary tract infection. Conclusion: APCNL is a safe procedure in well informed selective patients. These are the patients with small burden of stone and staying close to the hospital. APCNL reduces the hospital stay, expenses and results in early return to work.

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