软性输尿管镜下的辐射暴露，软性和可导航的输尿管吸入鞘：一项欧洲泌尿外科-泌尿内腔学会的多中心研究

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology Pub Date : 2025-07-01 DOI:10.1016/j.ajur.2025.01.002

Vineet Gauhar , Olivier Traxer , Thomas R.W. Herrmann , Daniele Castellani , Hatem Kamkoum , Wissam Kamal , Tzevat Tefik , Heng Chin Tiong , Mehmet Ilker Gökce , Michael Y.C. Wong , Khi Yung Fong , Ben Hall Chew , Manoj Monga , Vincent de Connick , Bhaskar Kumar Somani , Steffi Kar Kei Yuen

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引用次数: 0

摘要

目的探讨柔性输尿管镜（FURS）治疗肾结石术中使用柔性可导航的吸力输尿管通路鞘（FANS）对术中放射剂量和时间的影响。方法：本研究是一项多中心研究，研究对象为接受FURS合并FANS的成人。对术中c臂透视所测放射剂量和时间的影响因素进行相关性分析。结果我们分析了110例患者，中位年龄为50岁。其中72%的患者在手术前进行了支架植入。中位结石体积1503 mm3，中位手术时间39 min。中位辐射剂量为7.4 mSv，中位辐射时间为0.6 min。总的来说，91%的患者在术后30天内通过非对比CT扫描达到无结石状态（A级或B级）。术后无脓毒症发生。身体质量指数、结石体积和总手术时间与较高的辐射剂量有关。在全身麻醉下进行的手术比在脊髓麻醉下进行的手术有更低的辐射剂量和时间。一次性使用的照射镜比可重复使用的照射镜与更高的辐射时间相关，但与剂量无关。低功率钬激光器的辐射时间比其他激光源长，但只有铥光纤激光器的辐射剂量明显较低。结论我们的研究首次强调了影响FURS合并fan的辐射暴露的多种因素。虽然它不是外科医生实际辐射暴露的直接测量，但它对“尽可能低”原则具有重要意义，该原则通常用于最大限度地减少患者和手术室工作人员的辐射暴露。

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Radiation exposure in flexible ureteroscopy with a flexible and navigable suction ureteral access sheath: A European Association of Urology–Endourology multicenter study

Objective

We aimed to study the effect of flexible ureteroscopy (FURS) for renal stones using a flexible and navigable suction ureteral access sheath (FANS) on intraoperative radiation dose and time.

Methods

This was a multicenter study of adults who underwent FURS with FANS. The correlation analysis was done to identify factors affecting radiation dose and time measured by the C-arm fluoroscopy intraoperatively.

Results

We analyzed 110 patients, with a median age of 50 years. Of them, 72% were pre-stented prior to the procedure. The median stone volume was 1503 mm³ and the median operative time was 39 min. The median radiation dose was 7.4 mSv and median radiation time was 0.6 min. Totally, 91% of patients achieved stone-free status (Grade A or B) on the non-contrast CT scan within 30 days postoperatively. There were no cases of postoperative sepsis. Body mass index, stone volume, and total operation time were associated with a higher radiation dose. Procedures performed under general anesthesia had a lower radiation dose and time than those performed under spinal anesthesia. Disposable scopes were associated with higher radiation time than reusable scopes but not dose. A low-power holmium laser had longer radiation time than other laser sources, but only the thulium fiber laser was associated with a significantly lower radiation dose.

Conclusion

Our study is the first to highlight the multitude of factors affecting radiation exposure in FURS with FANS. Although not a direct measure of surgeons' actual exposure, it has important implications for the As Low As Reasonably Achievable principle which is commonly used to minimize radiation exposure to patients and operating room staff.

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来源期刊

Asian Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

4.00

自引率

3.80%

发文量

100

审稿时长

4 weeks

期刊介绍： Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.