Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?

doi:10.1016/j.ajur.2015.08.001

Asian Journal of Urology, 2015, 2 (4): 220-223 doi: 10.1016/j.ajur.2015.08.001

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Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?

Yasser A. Noureldin^a,b, Mohamed A. Elkoushy^a,c, Sero Andonian^a

a Division of Urology, McGill University Health Centre, Montreal, Québec, Canada;
b Department of Urology, Benha University Hospital, Benha University, Benha, Egypt c Department of Urology, Suez Canal University, Ismailia, Egypt

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Abstract Objective: The aim of this study was to assess whether the presence of a preformed percutaneous renal access (PCA) had any effects on fluoroscopy time (FT) during percutaneous nephrolithotomy (PCNL). Methods: After ethics approval was obtained, medical records of all patients who underwent PCNL between 2009 and 2013 at a tertiary stone referral centre were retrospectively reviewed. Patients with and without pre-formed PCA undergoing PCNL were compared. Patients who underwent second-look PCNL and those who had their access inserted by interventional radiology constituted the group with pre-formed PCA. Results: A total of 185 PCNLs were reviewed. The mean patient age was 55.2± 1.0 years with mean body mass index (BMI) of 27.8± 0.5 kg/m² and male gender of 63.8%. The mean stone size was 618.4± 47.0 mm² with mean Guy's grade of 2.3± 0.7 and mean S.T.O.N.E. score of 7.6± 0.1. The mean operative time was 98.7± 2.6 min with mean FT of 113.4± 4.5 s. The overall stone-free rate was 71.9% with complication rate of 16.2%. When compared with PCNLs without pre-formed PCA, PCNLs with pre-formed PCA were associated with significantly shorter FT (120.6± 5.1 vs. 77.5± 6.7 s; p < 0.001) and significantly lower estimated blood loss (EBL) (p = 0.01). On multivariate analysis, PCNLs with pre-formed PCA were associated with significantly shorter FT (B. coefficient =±43.2 (95%CI:±66.4 to±20); p < 0.001) and lower EBL (p = 0.02).

Key words： Fluoroscopy Percutaneous nephrolithotomy Renal access

Received: 07 April 2015 Published: 29 October 2015

Corresponding Authors: Sero Andonian E-mail: sero.andonian@muhc.mcgill.ca

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Yasser A. Noureldin,Mohamed A. Elkoushy,Sero Andonian. Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?[J]. Asian Journal of Urology, 2015, 2(4): 220-223.

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http://www.ajurology.com/EN/10.1016/j.ajur.2015.08.001 OR http://www.ajurology.com/EN/Y2015/V2/I4/220

[1]	Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf Jr JS, AUA Nephrolithiasis Guideline Panel. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 2005;173: 1991-2000.
[2]	Hellawell GO, Mutch SJ, Thevendran G, Wells E, Morgan RJ. Radiation exposure and the urologist: what are the risks? J Urol 2005;174:948-52.
[3]	Andonian S, Atalla MA. Radiation safety in urology. AUA update series, vol. 28; 2009. lesson 26.
[4]	Pierce DA, Preston DL. Radiation-related cancer risks at low doses among atomic bomb survivors. Radiat Res 2000;154: 178-86.
[5]	Brenner DJ, Hall EJ. Computed tomographyean increasing source of radiation exposure. N Engl J Med 2007;357: 2277-84.
[6]	Choi KH, Ha M, Lee WJ, Hwang SS, Jeong M, Jin YW, et al. Cancer risk in diagnostic radiation workers in Korea from 1996-2002. Int J Environ Res Public Health 2013;10:314-27.
[7]	Elkoushy MA, Andonian S. Prevalence of orthopedic complaints among endourologists and their compliance with radiation safety measures. J Endourol 2011;25:1609-13.
[8]	Tepeler A, Binbay M, Yuruk E, Sari E, Kaba M, Muslumanoglu AY, et al. Factors affecting the fluoroscopic screening time during percutaneous nephrolithotomy. J Endourol 2009;23:1825-9.
[9]	Mancini JG, Raymundo EM, Lipkin M, Zilberman D, Yong D, Bañez LL, et al. Factors affecting patient radiation exposure during percutaneous nephrolithotomy. J Urol 2010;184: 2373-7.
[10]	Noureldin YA, Elkoushy MA, Andonian S. Predictors of fluoroscopy time during percutaneous nephrolithotomy: impact of postgraduate urology trainees and S.T.O.N.E. nephrolithometry score. J Endourol 2015;29:542-7.
[11]	Shahrour W, Andonian S. Ambulatory percutaneous nephrolithotomy: initial series. Urology 2010;76:1288-92.
[12]	Noureldin YA, Elkoushy MA, Andonian S. Which is better? Guy's versus S.T.O.N.E. nephrolithometry scoring systems in predicting stone-free status post-percutaneous nephrolithotomy. World J Urol 2015 Feb 13 [Epub ahead of print].
[13]	de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, et al., CROES PCNL Study Group. Categorization of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 2012;62:246-55.
[14]	Elkoushy MA, Shahrour W, Andonian S. Pulsed fluoroscopy in ureteroscopy and percutaneous nephrolithotomy. Urology 2012;79:1230-5.
[15]	Blair B, Huang G, Arnold D, Li R, Schlaifer A, Anderson K, et al. Reduced fluoroscopy protocol for percutaneous nephrostolithotomy: feasibility, outcomes and effects on fluoroscopy time. J Urol 2013;190:2112-6.
[16]	Isac W, Rizkala E, Liu X, Noble M, Monga M. Endoscopic-guided versus fluoroscopic-guided renal access for percutaneous nephrolithotomy: a comparative analysis. Urology 2013;81: 251-6.
[17]	Lantz AG, O'Malley P, Ordon M, Jason Y, Lee JY. Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy. Can Urol Assoc J 2014;8:347-51.
[18]	Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol 2004;18:715-22.