to evaluate if 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 if this strategy would impact in operation time, stone free rate and complication rate.
from August 2016 to August 2017, patients over 18 years old submitted to ureteroscopy for ureteral stone between 5-20 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.
94 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 vs.16.2±19.3 mGy, p=0.0001 and 0.23±0.52 mcGycm2 vs. 1.15±2.74 mcGycm2, p=0.02, respectively). Fluoroscopy time was similar between groups (74.5±84.8 s vs. 88.3±90 s, p=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. .
Journal of endourology. 2019 Feb 22 [Epub ahead of print]
Alexandre Danilovic, Eduardo Nunes, Michael Eric Lipkin, Thiago Augusto Cunha Ferreira, Fabio Cesar Miranda Torricelli, Giovanni Scala Marchini, Miguel Srougi, William Carlos Nahas, Eduardo Mazzucchi
University of Sao Paulo Medical School, Sao Paulo, Brazil, Section of Endourology, Division of Urology São Paulo , Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175 , São Paulo, São Paulo, Brazil , 05403-000 ; ., University of Sao Paulo Medical School, Sao Paulo, Brazil, Section of Endourology, Division of Urology São Paulo, São Paulo, São Paulo, Brazil ; ., Duke University Medical Center, Surgery, Urology , DUMC 3167 , Durham, North Carolina, United States , 27710 ; ., University of Sao Paulo Medical School, Sao Paulo, Brazil, , Section of Endourology, Division of Urology São Paulo , 275 Francisco Cruz St , APT 173 , Vila Mariana , Sao Paulo, Brazil , 04117091 ; ., Universidade de Sao Paulo Faculdade de Medicina, 37884, Urology, Sao Paulo, SP, Brazil ; ., Hospital das Clínicas, University of Sao Paulo Medical School, Section of Endourology, Division of Urology, São Paulo, São Paulo, Brazil ; ., University of São Paulo Medical School, Division of Urology, São Paulo, São Paulo, Brazil ; ., Universidade de Sao Paulo Faculdade de Medicina Hospital das Clinicas, 117265, Urology, Sao Paulo, SP, Brazil ; ., Hospital das Clínicas, University of Sao Paulo Medical School, Division of Urology , barata ribeiro street,490 room25 , São Paulo, São Paulo, Brazil , 01308001 ; .