Radiation Exposure During Endourologic Procedures Using Over-the-Table Fluoroscopy Sources

Ritter, Manuel; Krombach, Patrick; Martinschek, A.; Siegel, Fabian; Schmitt, Martin; Weiß, Christel; Häcker, Axel; Pelzer, Alexandre

doi:10.1089/end.2011.0333

Cited by 38 publications

(20 citation statements)

References 15 publications

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“…pochodzące ze źródeł medycznych [2][3][4]. Z tego powodu Międzyna-rodowa Agencja Energii Atomowej (International Atomic Energy Agency -IAEA) i Międzynarodowa Komisja Ochrony Radiologicznej (International Commission on Radiological Protection -ICRP) od wielu lat zalecają, żeby osoby wykonujące procedury radiologii interwencyjnej były wyposażone w co najmniej 2 dozymetry indywidualne [5].…”

Section: Wstępunclassified

ERCP procedures as a source of radiation risk to a single gastroenterologist

Staniszewska¹,

Kujawski²,

Kopeć

et al. 2017

Med Pr

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StreszczenieWstęp: Wykorzystanie promieniowania rentgenowskiego (rtg.) w gastroenterologii stanowi jeden z licznych podobszarów radiologii interwencyjnej. W gastroenterologii fluoroskopia rtg. jest używana w procedurach terapeutycznych, z których częsta jest endoskopowa cholangiopankreatografia wsteczna (ECPW). Procedura ECPW pokazuje radiologiczny obraz dróg żółciowych i przewodu trzustkowego. Materiał i metody: W ramach niniejszej pracy przeprowadzono ocenę narażenia na promieniowanie rtg. gastroenterologa wykonującego zabiegi ECPW pod kontrolą fluoroskopii. Badania przeprowadzono w Pracowni ECPW Uniwersyteckiego Szpitala Klinicznego im. Wojskowej Akademii Medycznej -Centralnego Szpitala Weteranów w Łodzi, gdzie gastroenterolog wykonuje je samodzielnie. Realizując cel pracy, wykonano 2 serie pomiarów -pierwsza składała się z zabiegów wykonanych w trybie fluoroskopii ciągłej, druga -z zabiegów, które wykonano w trybie fluoroskopii impulsowej (o częstotliwo-ści 3 pulsy/s). Podczas każdej procedury rejestrowano parametry ekspozycji, dane anatomiczne pacjenta, a także otrzymywane przez gastroenterologa równoważniki dawek dla soczewek oczu i skóry dłoni oraz dawkę efektywną dla całego ciała. Wyniki: Zebrano dane dotyczące ogółem 70 zabiegów ECPW, w tym 40 zabiegów wykonanych w trybie fluoroskopii ciągłej i 30 -w trybie fluoroskopii impulsowej. Na podstawie uzyskanych wyników stwierdzono, że gastroenterolog wykonujący procedury ECPW w trybie fluoroskopii impulsowej otrzymuje dawki promieniowania niższe o 45-60% niż podczas pracy w trybie fluoroskopii ciągłej. Wnioski: Procedury ECPW mogą być źródłem narażenia na promieniowanie rtg. dla wykonującego je gastroenterologa. Używanie trybu fluoroskopii ciągłej może pozwolić na osiągnięcie obniżonej wartości rocznego limitu dawki równoważnej dla soczewek oczu (tj. 20 mSv), rekomendowanej przez Międzynarodową Komisję Ochrony Radiologicznej (International Commission on Radiological Protection -ICRP). Med. Pr. 2017;68(6):735-741 Słowa kluczowe: ekspozycja zawodowa, promieniowanie rtg., dawki, fluoroskopia, ECPW, gastroenterolog Abstract Background: One of the numerous sub-areas of interventional radiology is the use of X-rays in gastroenterology. X-ray fluoroscopy is applied in therapeutic procedures, including endoscopic retrograde cholangiopancreatography (ERCP) that is frequently performed. The ERCP procedure is aimed at imaging the pancreatic duct and biliary tracts. Material and Methods: In this paper radiation risk to the gastrenterologist performing ERCP procedures was investigated. The procedures were performed by a single gastroenterologist in the ERCP Laboratory, University Clinical Hospital Military Memorial Medical Academy -Central Veterans' Hospital in Łódź, Poland. The study comprised 2 series of measurements, one taken during the procedures with continuous fluoroscopy mode, the other during procedures with fluoroscopy in pulsed mode at a frequency of 3 pulses/s. Exposure parameters, anatomical data of patient and dose equivalents for the eyes, skin of the hand ...

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Section: Wstępunclassified

ERCP procedures as a source of radiation risk to a single gastroenterologist

Staniszewska¹,

Kujawski²,

Kopeć

et al. 2017

Med Pr

View full text Add to dashboard Cite

show abstract

“…This procedure has several advantages, including the ease of learning ability and operation [10,11]. But one disadvantage is the exposure of the staff to X-ray irradiation when fluoroscopy is used for entering into the collecting system and subsequent dilation [12]. To reduce the risk of the operating room staff being exposed to radiation, alternative techniques such as ultrasonography-guided renal access [13 ]have been suggested.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic versus Fluoroscopic Access for Percutaneous Nephrolithotomy: A Meta-Analysis

Wang¹,

Zhang²,

Xu³

et al. 2015

Urol Int

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Objective: To assess the safety and efficacy of ultrasonographic vs. fluoroscopic access for percutaneous nephrolithotomy (PCNL). Methods: Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify clinically controlled trials (CCTs) and randomized controlled trials (RCTs) that compared ultrasonographic access with fluoroscopic access for PCNL. RevMan 5.1 software and Stat Manager V4.1 software were used for the meta-analysis. Results: Five RCTs and nine CCTs were included in our study, which contained a total of 3,019 patients. Of these, 1,574 (52%) had undergone ultrasonographic access, and 1,445 (48%) had undergone fluoroscopic access. The pooled results revealed that the ultrasonographic access patients had shorter duration of access (min) by 2.56 min (weighted mean difference (WMD) = −2.56, 95% confidence interval (CI): −4.40 to −0.72, p = 0.006). There was a higher stone-free rate in the ultrasonographic access group (odds ratio (OR) = 1.26, 95% CI: 1.02-1.55, p = 0.03), as well as a lower rate of operative complications (OR = 0.72, 95% CI: 0.56-0.93, p = 0.01), reduced intraoperative blood loss (ml) (WMD = −14.55 ml, 95% CI: −27.65 to −1.46, p = 0.03), and a lower rate of blood transfusion requirement (OR = 0.39, 95% CI: 0.24-0.63, p = 0.0001). Sensitivity and subgroup analyses were also performed. Conclusion: Except for no radiation exposure, our meta-analysis revealed that ultrasonographic access had many advantages, such as a shorter access time, reduced intraoperative blood loss, a lower rate of operative complications, a lower rate of blood transfusion, and a higher stone-free rate. Because of these significant advantages, we recommend the use of ultrasonographic access for PCNL.

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“…The urologists, if they have proper knowledge about radiation hazards, can decrease the amount of radiation exposure. A multitude of measures can be taken to this effect [1,2]. Unfortunately, it has been seen in various studies that the urologists do not attribute significant attention towards radiation safety [3,4].…”

Section: Introductionmentioning

confidence: 99%

The Knowledge of Radiation and the Attitude Towards Radio-Protection among Urology Residents in India

Jindal¹

2015

JCDR

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Radiation Exposure During Endourologic Procedures Using Over-the-Table Fluoroscopy Sources

Abstract: This report evaluates surgeons' radiation exposure by everyday endourologic interventions of different complexity. Most can be performed with an over-the-table x-ray system without exceeding statutory limits. Especially for PCNL, surgeons should consider possible protective action.

Cited by 38 publications

References 15 publications

ERCP procedures as a source of radiation risk to a single gastroenterologist

ERCP procedures as a source of radiation risk to a single gastroenterologist

Ultrasonographic versus Fluoroscopic Access for Percutaneous Nephrolithotomy: A Meta-Analysis

The Knowledge of Radiation and the Attitude Towards Radio-Protection among Urology Residents in India

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