Pd36-09 retrospective comparison of fluoroless and conventional ureteroscopy

You have accessJournal of UrologyStone Disease: New Technology I1 Apr 2014PD36-09 RETROSPECTIVE COMPARISON OF FLUOROLESS AND CONVENTIONAL URETEROSCOPY Gaudencio Olgin, Gene O. Huang, Steven Engebretsen, Don C. Arnold, and D. Duane Baldwin Gaudencio OlginGaudencio Olgin More articles by this author , Gene O. HuangGene O. Huang More articles by this author , Steven EngebretsenSteven Engebretsen More articles by this author , Don C. ArnoldDon C. Arnold More articles by this author , and D. Duane BaldwinD. Duane Baldwin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2446AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary stone patients are exposed to significant amounts of radiation during their initial work-up, surgical treatment, and follow-up. In an effort to reduce patient exposure to ionizing radiation, a technique for ureteroscopy was developed that eliminated the need for intraoperative fluoroscopy. The purpose of this study was to compare outcomes of this technique with a cohort of conventional ureteroscopic patients. METHODS A retrospective review of 50 consecutive patients undergoing ureteroscopy using a completely fluoroless technique was performed. Fluoroless procedures were performed by inserting guide wires and instruments using tactile feedback, direct visualization, and external visual cues to substitute for fluoroscopy. This cohort was compared to 50 conventional ureteroscopies performed during this same period. Patient characteristics, perioperative factors, complication rates, and stone-free rates were compared. RESULTS All fluoroless ureteroscopies were successfully performed without image guidance. In the fluoroless group the mean operative time was 59.2 minutes (25-121 min.), overall stone burden was 91.5 mm2 (14-480 mm2), complication rate was 4%, and repeat procedure rate was 8%. When compared to conventional ureteroscopy, there was no statistical difference between operative time, complication rate, repeat procedure rate, age, gender, ASA, BMI, and laterality. The fluoroless patients had statistically larger stone burden 91.5 vs. 56.5 mm2 (p = 0.042) and more stones located in the kidney (p=0.002). The mean fluoroscopy time in the fluoroless group was significantly lower 0 (range 0-0 sec) compared to the mean fluoroscopy time during conventional ureteroscopy 38.6 sec (range 5-156; p<0.001). CONCLUSIONS Fluoroless ureteroscopy results in similar patient outcomes compared to conventional ureteroscopy, but results in dramatically reduced fluoroscopy time. Application of techniques employed for this procedure may be particularly useful in younger or pregnant patients and may be used to significantly lower radiation exposure in all patients. Future studies will be necessary to establish optimal patient selection criteria. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e904 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Gaudencio Olgin More articles by this author Gene O. Huang More articles by this author Steven Engebretsen More articles by this author Don C. Arnold More articles by this author D. Duane Baldwin More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...