Patel Rutveej, Dubin Justin, Olweny Ephrem O, Elsamra Sammy E, Weiss Robert E
Division of Urology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey , New Brunswick, New Jersey.
J Endourol. 2017 Sep;31(9):825-828. doi: 10.1089/end.2016.0454.
The lens of the eye is extremely susceptible to radiation and long-term exposure can induce cataract formation. Our objective was to explore the risk of cataract formation for urologists at our institution.
A retrospective review of a multisurgeon database of fluoroscopic cases between October 2013 to December 2014 was queried. Procedures were performed by different subspecialties and ranged from stent insertion/ureteroscopy to percutaneous nephrolithotomy. Fluoroscopic parameters were recorded from all cases and the radiation dosimetry was calculated through methods described by the National Council on Radiation Protection. The data were extrapolated to determine the risk of cataract formation. The technical specifications of the GE OEC 990 mobile C-arm unit were used for calculations.
A total of 780 cases were analyzed, of which 182 were endourology cases. Average fluoroscopic time was 34.86 seconds per case. Average tube potential and current were 86.84 kV and 1.95 mA, respectively. Pediatric urologists utilized fluoroscopy the least, 11.84 seconds per case (p = 0.0022). Endourology trained faculty had fluoroscopy exposure of 68.35 seconds per case (p < 0.0001), whereas others were exposed 26.24 seconds per case (p < 0.0001). For the highest exposed urologist, the estimated dose to the eyes was 5.64 μGy per case. Total estimated cumulative dose over the study timeframe was 997.58 μGy, or 748.19 μGy per year.
The defined threshold in the absorbed dose for cataract formation is 0.5 Gy. Resident exposure was the highest, at 11% of the annual limit, and the most exposed urologists had an estimated dose of 5% of the annual limit. At current exposure levels, it would not be feasible to reach the stated safety limit during 50 to 60 years of practice. However, changing exposure guidelines could result in stricter safety limits.
眼睛晶状体极易受到辐射影响，长期暴露可诱发白内障形成。我们的目的是探究我院泌尿外科医生患白内障的风险。
对2013年10月至2014年12月间多外科医生的透视病例数据库进行回顾性查询。手术由不同亚专业医生进行，范围从支架置入/输尿管镜检查到经皮肾镜取石术。记录所有病例的透视参数，并通过美国国家辐射防护委员会描述的方法计算辐射剂量学。对数据进行外推以确定白内障形成风险。使用GE OEC 990移动C型臂设备的技术规格进行计算。
共分析780例病例，其中182例为腔内泌尿外科病例。平均每例透视时间为34.86秒。平均管电压和电流分别为86.84 kV和1.95 mA。小儿泌尿外科医生使用透视最少，每例11.84秒（p = 0.0022）。接受腔内泌尿外科培训的教员每例透视暴露时间为68.35秒（p < 0.0001），而其他医生每例暴露26.24秒（p < 0.0001）。对于暴露量最高的泌尿外科医生，估计每例眼睛的剂量为5.64 μGy。研究时间段内估计的总累积剂量为997.58 μGy，即每年748.19 μGy。
白内障形成的吸收剂量定义阈值为0.5 Gy。住院医生的暴露量最高，为年度限值的11%，暴露量最高的泌尿外科医生估计剂量为年度限值的5%。在当前暴露水平下，在50至60年的执业期间达到规定的安全限值是不可行的。然而，改变暴露指南可能会导致更严格的安全限值。
