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Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy.

Publication ,  Journal Article
Lipkin, ME; Mancini, JG; Zilberman, DE; Raymundo, ME; Yong, D; Ferrandino, MN; Miller, MJ; Yoshizumi, TT; Preminger, GM
Published in: J Endourol
April 2011

INTRODUCTION: Fluoroscopy with retrograde pyelogram is commonly used to obtain access for percutaneous nephrolithotomy (PNL). Our practice uses room air for retrograde identification of calyceal anatomy. Herein we explore whether an air pyelogram was associated with a decrease in radiation exposure compared with standard retrograde pyelogram. METHODS: We retrospectively reviewed all PNL procedures performed at our institution over the past 2 years. Of the 260 PNL procedures performed during the study period, 96 had information on radiation dosage required for analysis. The effective dose (ED) was calculated using accepted conversion tables. Multivariable linear regression was used to determine the association between ED and the use of air pyelogram controlling for factors thought to affect radiation exposure. RESULTS: Of the 96 PNL procedures included in the study, 60 (63%) were performed with an air retrograde pyelogram (AP) and 36 (37%) used contrast retrograde pyelogram (CP). Both groups were matched in terms of age, body mass index, stone burden, and number of access tracts. Multivariable linear regression showed significantly lower radiation exposure in the AP group than in the CP group (p = 0.001). There was no difference in fluoroscopy time between the two groups. Using an AP lowered the mean adjusted ED nearly twofold, from 7.67 (CI = 5.99-9.81) to 4.45 (CI = 3.68-5.38) mSv. CONCLUSIONS: An air retrograde pyelogram is associated with decreased radiation exposure during PNL when compared with a contrast retrograde pyelogram.

Duke Scholars

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

April 2011

Volume

25

Issue

4

Start / End Page

563 / 567

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Urography
  • Nephrostomy, Percutaneous
  • Middle Aged
  • Male
  • Humans
  • Fluoroscopy
  • Female
  • Dose-Response Relationship, Radiation
 

Citation

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Lipkin, M. E., Mancini, J. G., Zilberman, D. E., Raymundo, M. E., Yong, D., Ferrandino, M. N., … Preminger, G. M. (2011). Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy. J Endourol, 25(4), 563–567. https://doi.org/10.1089/end.2010.0431
Lipkin, Michael E., John G. Mancini, Dorit E. Zilberman, Maria E. Raymundo, Daniel Yong, Michael N. Ferrandino, Michael J. Miller, Terry T. Yoshizumi, and Glenn M. Preminger. “Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy.J Endourol 25, no. 4 (April 2011): 563–67. https://doi.org/10.1089/end.2010.0431.
Lipkin ME, Mancini JG, Zilberman DE, Raymundo ME, Yong D, Ferrandino MN, et al. Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy. J Endourol. 2011 Apr;25(4):563–7.
Lipkin, Michael E., et al. “Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy.J Endourol, vol. 25, no. 4, Apr. 2011, pp. 563–67. Pubmed, doi:10.1089/end.2010.0431.
Lipkin ME, Mancini JG, Zilberman DE, Raymundo ME, Yong D, Ferrandino MN, Miller MJ, Yoshizumi TT, Preminger GM. Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy. J Endourol. 2011 Apr;25(4):563–567.
Journal cover image

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

April 2011

Volume

25

Issue

4

Start / End Page

563 / 567

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Urography
  • Nephrostomy, Percutaneous
  • Middle Aged
  • Male
  • Humans
  • Fluoroscopy
  • Female
  • Dose-Response Relationship, Radiation