Bailly M, Zinsius A, Maia S, Santiago Ribeiro M-J
Service de médecine nucléaire, hôpital Bretonneau, CHRU-hôpitaux de Tours, 2, boulevard Tonnelé, 37000 Tours, France.
Service de médecine nucléaire, hôpital Bretonneau, CHRU-hôpitaux de Tours, 2, boulevard Tonnelé, 37000 Tours, France; Service compétent en radioprotection, hôpital Bretonneau, CHRU-hôpitaux de Tours, 2, boulevard Tonnelé, 37000 Tours, France.
Gynecol Obstet Fertil. 2014 May;42(5):296-300. doi: 10.1016/j.gyobfe.2014.01.007. Epub 2014 Feb 16.
Assess the radiation exposure of surgical staff during sentinel node surgery in gynecology using a radiotracer, the (99m)Tc-microalbumin.
A monocentric, prospective study was conducted during 3 months representing 40 sentinel node surgical procedures with different dosimetric measurements. Dosimeters were used to evaluate the whole body and the fingers radiation exposure for all exposed workers (surgeon, nurse and surgical assistant). Another dosimeter was used to estimate the atmospheric radiation level. The activity of (99m)Tc-microalbumin was 50.1±2.4MBq when the surgery was performed the same day and 90.4±3.2MBq when the surgery was performed the day after.
Radioactive doses received during each procedure by the surgeon, surgical assistant and nurse are 5, 3.75 and 0μSv for whole body exposure and 17.5, 15.6 and 16.2μSv for extremities respectively. Atmosphere dosimeter does not detect any radiation over this period. On average, 200 procedures are performed each year in our hospital by 7 surgeons. Surgeon's radiation exposure remains below the threshold of 1mSv annual for whole body and 50mSv annual for fingers set for public by the International Commission on Radiological Protection.
During sentinel node surgery radiation exposure of surgical staff is weak. Everyone, including the surgeon, receives a dose below the limits of the public radiation exposure. There is no need for special dosimetric monitoring or use radiation protective devices during the sentinel node surgery using (99m)Tc-microalbumin injection.
使用放射性示踪剂（99m）锝-微白蛋白评估妇科前哨淋巴结手术中手术人员的辐射暴露情况。
进行了一项单中心前瞻性研究，为期3个月，涵盖40例不同剂量测量的前哨淋巴结手术。使用剂量计评估所有暴露工作人员（外科医生、护士和手术助手）的全身及手指辐射暴露情况。另一个剂量计用于估计大气辐射水平。手术当天进行手术时，（99m）锝-微白蛋白的活度为50.1±2.4MBq，手术次日进行手术时为90.4±3.2MBq。
外科医生、手术助手和护士在每次手术中全身暴露所接受的放射性剂量分别为5、3.75和0μSv，四肢暴露所接受的剂量分别为17.5、15.6和16.2μSv。在此期间，大气剂量计未检测到任何辐射。我院平均每年由7名外科医生进行200例手术。外科医生的辐射暴露全身仍低于国际放射防护委员会为公众设定的每年1mSv的阈值，手指暴露低于每年50mSv的阈值。
在前哨淋巴结手术中，手术人员的辐射暴露较低。包括外科医生在内的每个人所接受的剂量均低于公众辐射暴露限值。在使用（99m）锝-微白蛋白注射进行前哨淋巴结手术期间，无需进行特殊的剂量监测或使用辐射防护设备。
