Reduced Radiation Exposure with the Use of an Air Retrograde Pyelogram During Fluoroscopic Access for Percutaneous Nephrolithotomy

Abstract

An air retrograde pyelogram is associated with decreased radiation exposure during PNL when compared with a contrast retrograde pyelogram.

Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy

“…The median BMI of our study population is within the reported range in our geographic area 23 and is comparable to similar PCNL studies reporting BMI. 15,19,20,24 The mean fluoroscopy time in our study cohort was only 3.4 minutes, which is shorter than most case series using standard PCNL techniques (Table 4), and the mean effective dose of 2.4 mSv in our cohort compares favourably to published reports. For standard PCNL using contrast pyelography, Lipkin and colleagues 24 reported a mean fluoroscopy time about 3 times the amount in our study cohort.…”

“…15,19,20,24 The mean fluoroscopy time in our study cohort was only 3.4 minutes, which is shorter than most case series using standard PCNL techniques (Table 4), and the mean effective dose of 2.4 mSv in our cohort compares favourably to published reports. For standard PCNL using contrast pyelography, Lipkin and colleagues 24 reported a mean fluoroscopy time about 3 times the amount in our study cohort. In 2010, Mancini and colleagues 19 reported a retrospective review of 96 cases of standard PCNL.…”

Limiting Radiation Exposure During Percutaneous Nephrolithotomy

“…A retrospective review of 92 patients in which PCNL access was achieved with the use of air nephrograms rather than with iodinated contrast showed an approximately 50% reduction in radiation exposure. 16 As with obese patients, the mechanism for this is from the increased voltage of the C-arm to compensate for the dense contrast in comparison with the surrounding tissue. Data on the use of ureteroscopic guided PCNL puncture has been presented with relatively low STs and radiation exposure-4.2 minutes and 2.8 mSv, respectively.…”

Evaluating Parameters Affecting Fluoroscopy Time During Percutaneous Nephrolithotomy: Focus on the Predictive Role of Guy's, S.T.O.N.E., and CROES Scoring Systems

“…The goal of the present study was to identify clinical, imaging and intraoperative parameters that increase FT during PCNL in order to enhance our knowledge on this 65% and 35% decrease in FT, respectively [21,22]. The implementation of a reduced fluoroscopy protocol was associated with an 80% decrease in FT [3].…”