Assessing radiation exposure during endoscopic-guided percutaneous nephrolithotomy.

Area of Science:

• Urology
• Medical Imaging
• Radiation Safety

Background:

• Percutaneous nephrolithotomy (PCNL) carries risks of significant ionizing radiation exposure for patients and staff.
• Endoscopic-guided PCNL (ePCNL) presents a potential alternative to minimize this exposure.

Purpose of the Study:

• To examine radiation exposure metrics (fluoroscopy time, effective dose) associated with ePCNL.
• To identify variables that may predict increased radiation exposure during ePCNL procedures.

Main Methods:

• Retrospective review of 55 consecutive ePCNL cases performed by a single surgeon.
• Analysis of patient demographics, stone characteristics, and perioperative details, including radiation exposure.
• Correlation analysis using Pearson and Spearman methods to identify predictors of radiation exposure.

Main Results:

• Mean fluoroscopy time was 3.4 minutes and mean effective dose (ED) was 2.4 mSv.
• Increased stone size, longer operative time, and lower treatment success rates correlated with longer fluoroscopy time.
• Higher ED correlated with longer fluoroscopy time and increased skin-to-stone distance.
• Body mass index (BMI) did not correlate with fluoroscopy time or ED.

Conclusions:

• ePCNL demonstrates outcomes comparable to traditional PCNL.
• ePCNL may offer reduced radiation exposure, particularly beneficial for patients with higher BMI.
• Stone size and operative time are key factors influencing radiation exposure in ePCNL.