Abid N, Ravier E, Codas R, Crouzet S, Martin X
Service d'urologie et chirurgie de la transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
Prog Urol. 2013 Sep;23(10):856-60. doi: 10.1016/j.purol.2013.03.007. Epub 2013 May 16.
Extracorporeal shock wave lithotripsy is the most common method of treatment for kidney stones. Both fluoroscopy and ultrasound imaging can be used to locate stones, but fluoroscopy is more frequently employed. Evaluation of a new stereotaxic navigational system: the stone was located using an ultrasound probe, and its 3D location was saved. The table automatically moved to position the stone at the focal point. A real-time follow-up was possible during treatment. Our objective was to demonstrate a decrease in the use of fluoroscopy to locate kidney stones for extracorporeal shock wave lithotripsy through the use of a 3D ultrasound stone locking system.
Prospective analysis of the case records of the 20 patients preceding and the 20 patients succeeding the arrival of the ultrasound stone locking system Visio-Track (EDAP-TMS). We used a Student test to compare age, BMI, kidney stone size, number of shock waves and administered energy.
Patient characteristics were comparable. The average age was 55 years old and the average kidney stone size was 10.7 mm. Radiation duration was 174.8 seconds in the group without Visio-Track versus 57.1 seconds in the group with it (P<0.0001). A similar result was observed for radiation doses: 5197.25 mGy x cm2 for the group without versus 1987.6 mGy x cm2 for the group with Visio-Track (P=0.0033).
The stone locking system Visio-Track reduced fluoroscopy in our first group of patients, which decreased the patient's individual absorbed irradiation dose.
体外冲击波碎石术是治疗肾结石最常用的方法。透视和超声成像均可用于结石定位,但透视的应用更为频繁。对一种新型立体定向导航系统的评估:使用超声探头定位结石,并保存其三维位置。手术台自动移动将结石置于焦点处。治疗过程中可进行实时跟踪。我们的目的是通过使用三维超声结石锁定系统,证明在体外冲击波碎石术中用于定位肾结石的透视使用量减少。
对超声结石锁定系统Visio-Track(EDAP-TMS)到货之前的20例患者和到货之后的20例患者的病例记录进行前瞻性分析。我们使用学生检验比较年龄、体重指数、肾结石大小以及冲击波次数和施加的能量。
患者特征具有可比性。平均年龄为55岁,平均肾结石大小为10.7毫米。无Visio-Track组的透视持续时间为174.8秒,有该系统组为57.1秒(P<0.0001)。透视剂量也观察到类似结果:无该系统组为5197.25 mGy×cm²,有Visio-Track组为1987.6 mGy×cm²(P=0.0033)。
结石锁定系统Visio-Track减少了我们第一组患者的透视使用,从而降低了患者个体的吸收辐射剂量。