MP30-13 PREOPERATIVE FACTORS AFFECTING RADIATION TIME DURING PERCUTANEOUS NEPHROLITHOTOMY: A MULTI-INSTITUTIONAL ANALYSIS

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You have accessJournal of UrologyStone Disease: Surgical Therapy III1 Apr 2015MP30-13 PREOPERATIVE FACTORS AFFECTING RADIATION TIME DURING PERCUTANEOUS NEPHROLITHOTOMY: A MULTI-INSTITUTIONAL ANALYSIS Zhamshid Okhunov, Vincent Bird, Arash Akhavein, Daniel Moreira, Arvin George, Sammy Elsamra, Brian Duty, Michael Del Junco, Fotima Asquarova, Michael Rothberg, Mantu Gupta, Chad Tracy, Mark Newton, Kevan Sternberg, Benjamin King, Edan Shapiro, Jorge Moreno, Christopher Pulford, Juan Carlos Rosales, Arun Srinivasan, Yasser Noureldin, Sero Andonian, Nazih Khater, Duane Baldwin, Khurshid Ghani, Maksim Shlykov, Ramy Youssef, Brian Shinsky, Justin Friedlander, Steven Nakada, Stuart Wolf Jr., Arthur D. Smith, Zeph Okeke, and Jaime Landman Zhamshid OkhunovZhamshid Okhunov More articles by this author , Vincent BirdVincent Bird More articles by this author , Arash AkhaveinArash Akhavein More articles by this author , Daniel MoreiraDaniel Moreira More articles by this author , Arvin GeorgeArvin George More articles by this author , Sammy ElsamraSammy Elsamra More articles by this author , Brian DutyBrian Duty More articles by this author , Michael Del JuncoMichael Del Junco More articles by this author , Fotima AsquarovaFotima Asquarova More articles by this author , Michael RothbergMichael Rothberg More articles by this author , Mantu GuptaMantu Gupta More articles by this author , Chad TracyChad Tracy More articles by this author , Mark NewtonMark Newton More articles by this author , Kevan SternbergKevan Sternberg More articles by this author , Benjamin KingBenjamin King More articles by this author , Edan ShapiroEdan Shapiro More articles by this author , Jorge MorenoJorge Moreno More articles by this author , Christopher PulfordChristopher Pulford More articles by this author , Juan Carlos RosalesJuan Carlos Rosales More articles by this author , Arun SrinivasanArun Srinivasan More articles by this author , Yasser NoureldinYasser Noureldin More articles by this author , Sero AndonianSero Andonian More articles by this author , Nazih KhaterNazih Khater More articles by this author , Duane BaldwinDuane Baldwin More articles by this author , Khurshid GhaniKhurshid Ghani More articles by this author , Maksim ShlykovMaksim Shlykov More articles by this author , Ramy YoussefRamy Youssef More articles by this author , Brian ShinskyBrian Shinsky More articles by this author , Justin FriedlanderJustin Friedlander More articles by this author , Steven NakadaSteven Nakada More articles by this author , Stuart Wolf Jr.Stuart Wolf Jr. More articles by this author , Arthur D. SmithArthur D. Smith More articles by this author , Zeph OkekeZeph Okeke More articles by this author , and Jaime LandmanJaime Landman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.595AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous nephrolithometry (PCNL) may be associated with significant ionizing radiation exposure for patients and operating room personnel. We conducted a multicenter study to assess the predictors of increased radiation exposure during PCNL. METHODS We performed a multicenter retrospective review of patients undergoing PCNL. Patient demographics, stone characteristics and perioperative data including fluoroscopy time were recorded and analyzed. Preoperative CT images were reviewed and S.T.O.N.E. score was assigned to each patient. RESULTS A total of 1700 patients were included in the analysis. The mean age and body mass index (BMI) were 63.4±15 and 31.2±7kg/m2 respectively. Mean stone size and mean overall nephrolithometry score was 3.7 and 8.3 (SD=2.2) respectively. Overall single procedure stone-free rate was 72%. In logistic regression analysis, stone size (p<0.01), number of calyces (p<0.01), BMI (p<0.01), longer procedure time (p<0.01), skin-to-stone distance (p<0.01) and S.T.O.N.E. score (p<0.01) were significantly associated with increased fluoroscopy time. Stone-free patients had statistically significant lower radiation exposure compared to patients with residual stones (8.7 vs. 16.9 minutes, respectively; P<0.001). On average, for each increase in one unit of S.T.O.N.E score, there was additional 1.5 minutes of fluoroscopy time. In risk stratification, low-risk patients with 5-7 scores had 7.8 minutes of fluoroscopy time, compared to medium-risk (8-10) and high-risk patients (11-13) who had 12.8 and 15.8 minutes of fluoroscopy time, respectively (p=0.001). CONCLUSIONS In this multicenter study, patients with greater stone size, BMI, number of calyces, skin-to-stone distance and S.T.O.N.E. nephrolithometry were associated with increased radiation exposure during PCNL. Alternative modified pulsed fluoroscopy techniques or radiation-free imaging modalities such as ultrasound should be used in order to reduce the amount of ionizing radiation during the PCNL procedures. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCanales B, Sinclair L, Kang D, Mench A, Arreola M and Bird V (2015) Changing Default Fluoroscopy Equipment Settings Decreases Entrance Skin Dose in PatientsJournal of Urology, VOL. 195, NO. 4 Part 1, (992-997), Online publication date: 1-Apr-2016. Volume 193Issue 4SApril 2015Page: e352 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zhamshid Okhunov More articles by this author Vincent Bird More articles by this author Arash Akhavein More articles by this author Daniel Moreira More articles by this author Arvin George More articles by this author Sammy Elsamra More articles by this author Brian Duty More articles by this author Michael Del Junco More articles by this author Fotima Asquarova More articles by this author Michael Rothberg More articles by this author Mantu Gupta More articles by this author Chad Tracy More articles by this author Mark Newton More articles by this author Kevan Sternberg More articles by this author Benjamin King More articles by this author Edan Shapiro More articles by this author Jorge Moreno More articles by this author Christopher Pulford More articles by this author Juan Carlos Rosales More articles by this author Arun Srinivasan More articles by this author Yasser Noureldin More articles by this author Sero Andonian More articles by this author Nazih Khater More articles by this author Duane Baldwin More articles by this author Khurshid Ghani More articles by this author Maksim Shlykov More articles by this author Ramy Youssef More articles by this author Brian Shinsky More articles by this author Justin Friedlander More articles by this author Steven Nakada More articles by this author Stuart Wolf Jr. More articles by this author Arthur D. Smith More articles by this author Zeph Okeke More articles by this author Jaime Landman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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