1 Department of Urology, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
2 Division of Urologic Surgery, Surgery Department, Duke University Medical Center, Durham, North Carolina.
J Endourol. 2019 Jul;33(7):527-532. doi: 10.1089/end.2018.0722.
To evaluate whether reducing the dose of fluoroscopy to ¼ of standard dose during unilateral ureteroscopy for ureteral stone treatment would impact in a reduction of total radiation emitted and whether this strategy would impact operation time, stone-free rate, and complication rate. From August 2016 to August 2017, patients over 18 years submitted to ureteroscopy for ureteral stone between 5 and 20 mm were prospectively randomized for ¼ dose reduction or standard dose fluoroscopy. Patients with abnormal urinary anatomy such as horseshoe kidney, pelvic kidney, or duplex system were excluded from the study. Ninety-four patients were enrolled. The fluoroscopic dose reduction strategy to ¼ of the standard dose was able to significantly reduce the cumulative radiation emitted by C-arm fluoroscopy and the dose area product (3.6 ± 4.5 mGy 16.2 ± 19.3 mGy, = 0.0001 and 0.23 ± 0.52 mcGycm 1.15 ± 2.74 mcGycm, = 0.02, respectively). Fluoroscopy time was similar between groups (74.5 ± 84.8 seconds 88.3 ± 90 seconds, = 0.44). There was no need to increase the fluoroscopy dose during any of the procedures. Surgical outcomes were not affected by fluoroscopic dose reduction strategy. Low dose fluoroscopy reduces the emitted radiation during ureteroscopy without compromising surgical outcomes.
为了评估在单侧输尿管镜治疗输尿管结石时将透视剂量减少到标准剂量的四分之一是否会减少总辐射量，以及这种策略是否会影响手术时间、结石清除率和并发症发生率。2016 年 8 月至 2017 年 8 月，前瞻性随机选择了 18 岁以上、结石大小为 5 至 20mm 的输尿管镜患者进行四分之一剂量减少或标准剂量透视。患有马蹄肾、盆腔肾或双肾盂系统等异常尿路解剖的患者被排除在研究之外。共纳入 94 例患者。透视剂量减少至标准剂量的四分之一策略能够显著减少 C 臂透视的累积辐射量和剂量面积乘积（3.6±4.5mGy 16.2±19.3mGy，=0.0001 和 0.23±0.52mcGycm 1.15±2.74mcGycm，=0.02）。两组透视时间相似（74.5±84.8 秒 88.3±90 秒，=0.44）。在任何手术过程中都不需要增加透视剂量。手术结果不受透视剂量减少策略的影响。低剂量透视可减少输尿管镜手术过程中的辐射量，而不会影响手术结果。
