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01.12.2024 | Original Article

Radiation exposure of patients during endourological procedures

verfasst von: Vincent De Coninck, Xavier Mortiers, Laura Hendrickx, Stefan De Wachter, Olivier Traxer, Etienne X. Keller

Erschienen in: World Journal of Urology | Ausgabe 1/2024

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Abstract

Purpose

Considering the existing gaps in the literature regarding patient radiation dose (RD) and its associated risks, a systematic review of the literature on RD was conducted, focusing on percutaneous nephrolithotomy (PCNL), extracorporeal shock wave lithotripsy (SWL), and ureteroscopy (URS).

Methods

Two authors conducted a literature search on PubMed, Web of Science, and Google Scholar to identify studies on RD during endourological procedures. Two thousand two hundred sixty-six articles were screened. Sixty-five publications met the inclusion criteria using the PRISMA standards.

Results

RD was generally highest for PCNL, reaching levels up to 33 mSv, 28,700 mGycm², and 430.8 mGy. This was followed by SWL, with RD reaching up to 7.32 mSv, 13,082 mGycm², and 142 mGy. URS demonstrated lower RD, reaching up to 6.07 mSv, 8920 mGycm², and 46.99 mGy. Surgeon experience and case load were inversely associated with RD. Strategies such as optimizing fluoroscopy settings, implementing ultrasound (US), and following the ALARA (As Low As Reasonably Achievable) principle minimized RD.

Conclusions

This is the first systematic review analyzing RD, which was generally highest during PCNL, followed by SWL and URS. There is no specific RD limit for these procedures. Implementation of strategies such as optimizing fluoroscopy settings, utilizing US, and adhering to the ALARA principle proved effective in reducing RD. However, further research is needed to explore the factors influencing RD, assess their impact on patient outcomes, and establish procedure-specific reference levels for RD.

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Titel: Radiation exposure of patients during endourological procedures
verfasst von: Vincent De Coninck
Xavier Mortiers
Laura Hendrickx
Stefan De Wachter
Olivier Traxer
Etienne X. Keller
Publikationsdatum: 01.12.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 1/2024
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04953-y

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Radiation exposure of patients during endourological procedures

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