Can ultrasound guided fluoroscopy efficiently reduce radiation time & dose in mini-PCNL in children, a prospective randomized trial.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY Urology Pub Date : 2025-03-13 DOI:10.1016/j.urology.2025.03.012

Amr K Salama, Mahmoud A ElSabbagh, Ahmed M Fahmy, Mohamed Youssif, Haytham Badawy, Assem Ghozlan, Waleed A Dawood

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引用次数: 0

Abstract

Objective: To assess how much can fluoroscopy assisted US guided puncture reduce radiation exposure in PCNL, and can it achieve equivalent results compared to the traditinoal fluorosocpy technique in PCNL.

Methods: From July 2022 to August 2023, 50 patients receiving mini-percutaneous nephrolithotomy (mini-PCNL) were included in a prospective randomized study. Two groups of twenty-five patients each were formed. Those in Group A received fluoroscopy-only guided (FG) puncture, whereas those in Group B received fluoroscopy assisted ultrasound guided (FUSG) puncture. Analysis was done on the following variables: stone-free rate, complication rate, fluoroscopy time, and demographic data.

Results: Mean age in group A compared to group B was 7.24 ± 3.72 vs. 8.0 ± ±3.77 years respectively. The addition of ultrasonic guiding resulted in a considerable reduction in fluoroscopy duration, from 157.9 ± 68.54 seconds in group A to 29.44 ± 17.01 seconds in group B (p < 0.05). The radiation dosage was significantly lower in group B (6.07 ± 3.57) mGy compared to group A (32.35 ± 13.79) mGy (p < 0.05). In group A, the time to puncture was 136.6 ± 50.78 (sec), but in group B, it was 52.20 ± 33.20 (sec) (p < 0.05). The universal stone-free rate was 95.3%, with no discernible statistical trend. Group A's complications rate was 16%, while group B reported complication rate of 12%, with no statistically significant difference (p 0.653).

Conclusion: fluoroscopy-assisted ultrasound guidance in Mini-PCNL is a safer and more effective approach than fluoroscopy alone in our experince.

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目的评估透视辅助下的US引导穿刺能在多大程度上减少PCNL中的辐射暴露，以及与传统的PCNL透视技术相比能否达到同等效果：方法：2022 年 7 月至 2023 年 8 月，50 名接受迷你经皮肾镜取石术（mini-PCNL）的患者被纳入一项前瞻性随机研究。研究分为两组，每组 25 名患者。A 组接受纯透视引导（FG）穿刺，B 组接受透视辅助超声引导（FUSG）穿刺。对以下变量进行了分析：无结石率、并发症发生率、透视时间和人口统计学数据：结果：A 组的平均年龄为 7.24 ± 3.72 岁，B 组为 8.0 ± ± 3.77 岁。加入超声引导后，透视时间大大缩短，从 A 组的 157.9 ± 68.54 秒缩短到 B 组的 29.44 ± 17.01 秒（P < 0.05）。与 A 组（32.35 ± 13.79）毫戈瑞相比，B 组的辐射剂量（6.07 ± 3.57）毫戈瑞明显降低（P < 0.05）。A 组的穿刺时间为 136.6 ± 50.78（秒），而 B 组为 52.20 ± 33.20（秒）（P < 0.05）。无结石率为 95.3%，无明显统计学趋势。A 组的并发症发生率为 16%，而 B 组的并发症发生率为 12%，差异无统计学意义（P 0.653）。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.