Can Ultrasound Guided Fluoroscopy Efficiently Reduce Radiation Time and Dose in Mini-Percutaneous Nephrolithotomy in Children, a Prospective Randomized Trial
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 ultrasound guided puncture reduce radiation exposure in percutaneous nephrolithotomy (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-PCNL were included in a prospective randomized study. Two groups of 25 patients each were formed. Those in group A received fluoroscopy-only guided puncture, whereas those in group B received fluoroscopy assisted ultrasound guided 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 < .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 < .05). In group A, the time to puncture was 136.6 ± 50.78 (second), but in group B, it was 52.20 ± 33.20 (second) (P < .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 .653).
Conclusion
Fluoroscopy-assisted ultrasound guidance in mini-PCNL is a safer and more effective approach than fluoroscopy alone in our experience.
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.
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