Sarikaya Selcuk, Senocak Cagri, Selvi Ismail, Ozbek Ridvan, Bozkurt Omer Faruk
Department of Urology. Gulhane Research and Training Hospital. Ankara. Turkey.
Department of Urology. Kecioren Research and Training Hospital. Ankara. Turkey.
Arch Esp Urol. 2018 Nov;71(9):772-781.
Fluoroscopy is used for access sheath insertion and postoperative control during retrograde intrarenal surgery (RIRS) operation but with this technique both patient and operation team are exposed to radiation. The use of fluoroscopy is disadvantage for both patient and surgeon. Considering results of recent studies, it is clearly seen that fluoroscopy doesn't affect the success and complication rates of RIRS. In this study, we aimed to compare the results of both fluoroscopy and fluoroscopy-free groups, to show if there is a significant difference.
385 patients were included in the study and they were divided into two groups. 284 patients were in Group I where fluoroscopy was used. 101 patients were in Group II and fluoroscopy was not used The success rates of primary operation and final success rates were compared. Data from both groups were evaluated objectively using classification systems and imaging methods.
Success rates (primary and final) were higher in Group II, and that can be attributed to experience gained over time. Complication rate was lower and success rate was higher in fluoroscopy-free group. According to multivariate analysis, It is clear that the stone dimension is the foreground of the factors that influence the success, and the effect of the stone location is also observed.
When considering the comparison of success and complication rates between two groups, it is clearly understood that the use of fluoroscopy has not a positive effect on results. According to the outcomes of our study, fluoroscopy-free RIRS can be performed with safe and high success rates. This outcome also leads an important point for avoiding unnecessary radiation exposure.
在逆行性肾内手术（RIRS）中，荧光透视法用于引导鞘管插入及术后检查，但采用该技术时患者和手术团队都会受到辐射。荧光透视法的使用对患者和外科医生均不利。从近期研究结果可以清楚地看出，荧光透视法并不影响RIRS的成功率和并发症发生率。在本研究中，我们旨在比较使用荧光透视法和不使用荧光透视法两组的结果，以显示是否存在显著差异。
385例患者纳入本研究并分为两组。第一组284例患者使用荧光透视法，第二组101例患者不使用荧光透视法。比较初次手术成功率和最终成功率。使用分类系统和成像方法对两组数据进行客观评估。
第二组的成功率（初次和最终）更高，这可归因于随着时间推移积累的经验。无荧光透视组的并发症发生率较低，成功率较高。根据多变量分析，显然结石大小是影响成功的首要因素，结石位置的影响也得到观察。
在考虑两组成功率和并发症发生率的比较时，可以清楚地认识到荧光透视法的使用对结果没有积极影响。根据我们的研究结果，不使用荧光透视法的RIRS可以安全且高成功率地进行。这一结果对于避免不必要的辐射暴露也具有重要意义。
