FEASIBILITY AND SAFETY OF FLUOROLESS URETERORENOSCOPY- OUR INSTITUTIONAL EXPERIENCE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 53
Abstract
BACKGROUND Patients with urolithiasis are exposed to significant amounts of radiation during preoperative workup by means of X-ray, conventional contrast imaging and CECT during surgery and followup. The purpose of this study was to determine the feasibility of performing ureterorenoscopy without fluoroscopic aid. In addition, we compared this technique with conventional fluoroscopic ureterorenoscopy. MATERIALS AND METHODS This is a retrospective analysis of hospital records based study in which 50 patients of mid and lower ureteric calculus undergoing fluoroless ureterorenoscope in our institution from August 2015 to December 2016 were reviewed retrospectively. These procedures were performed safely by inserting guide wires and instruments using tactile feedback, direct visualisation, and external visual cues to substitute for fluoroscopy. Single shot X-ray was done at the end to confirm the position of stent. In addition, this cohort was compared with 50 conventional, fluoroscopy-guided ureterorenoscopies performed in the same time period. RESULTS Fifty ureterorenoscopies were performed without c-arm guidance. In these group of patients, the mean operative time was 57.30 minutes, the mean stone burden was 61.1 mm2, complication rate was 6%, and repeat procedure rate was 7%. Compared with conventional ureterorenoscopy, the fluoroless ureterorenoscopy patients had a similar age, gender, body-mass index, operative time but lesser mean stone burden (61.16 vs. 66.58 mm2) and lesser repeat procedure rate. CONCLUSION This study demonstrates the feasibility, safety and efficacy of the completely fluoroless ureterorenoscopic treatment of mid and lower ureteric calculi while completely avoiding radiation exposure to the patients and staff. Apart from its usefulness in high risk patients like pregnant women, children and recurrent calculus patients, this fluoroless technique offers an alternative for reduction of radiation in all patients.
Authors and Affiliations
Balaji Appiya Ramamoorthy, Sangameswaran Palanisamy
Keywords
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- EP ID EP220263
- DOI 10.14260/Jemds/2017/866
- Views 93
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