Pd54-01 using intraoperative portable ct scan to minimize reintervention rates in pcnl: a prospective trial

You have accessJournal of UrologyStone Disease: Surgical Therapy IV (PD54)1 Sep 2021PD54-01 USING INTRAOPERATIVE PORTABLE CT SCAN TO MINIMIZE REINTERVENTION RATES IN PCNL: A PROSPECTIVE TRIAL Parth Patel, Alexander Kandabarow, Eric Chuang, Kevin McKenzie, Aleksader Druck, Christopher Seffren, Edward Capoccia, Ahmer Farooq, Jeffrey Branch, Thomas Turk, and Kristin Baldea Parth PatelParth Patel More articles by this author , Alexander KandabarowAlexander Kandabarow More articles by this author , Eric ChuangEric Chuang More articles by this author , Kevin McKenzieKevin McKenzie More articles by this author , Aleksader DruckAleksader Druck More articles by this author , Christopher SeffrenChristopher Seffren More articles by this author , Edward CapocciaEdward Capoccia More articles by this author , Ahmer FarooqAhmer Farooq More articles by this author , Jeffrey BranchJeffrey Branch More articles by this author , Thomas TurkThomas Turk More articles by this author , and Kristin BaldeaKristin Baldea More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002081.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Up to 60% of patients undergoing initial percutaneous nephrolithotomy (PCNL) ultimately require further interventions due to residual stone fragments. Portable CT scanning (PCT) can allow cross-sectional imaging to be obtained intraoperatively—rather than post-operatively—allowing surgeons to extract residual stones and reducing the need for subsequent procedures. We sought to evaluate how this technology affects the need for subsequent interventions, length of stay, and radiation dose to the patient. METHODS: We prospectively enrolled all eligible patients undergoing initial PCNL for this trial (n=37), allowing them to undergo a single intraoperative CT-abdomen and ipsilateral antegrade ureteroscopy during initial PCNL. These patients were then compared to a retrospective cohort of all patients undergoing initial PCNL at our institution in 2018-2019 (n=178). We studied their perioperative imaging, intraoperative findings, and postoperative clinical courses. Univariate analysis was performed using chi-squared and student’s t-tests. RESULTS: There was no difference between the two cohorts regarding demographic properties, stone characteristics, or location of percutaneous access. Of the patients enrolled, 89% underwent PCT, 52% of PCT scans identified residual fragments prompting continuation of surgery, and 88% of these patients were rendered stone-free within the same operation. The prospective cohort had significantly lower rate of 90-day reintervention (2.7% vs. 31.5%, p<0.01), fewer perioperative complications (0% vs. 9.6%, p=0.049), reduced CT-based radiation dose (975 mGy*cm vs. 511, p<0.01), and shorter length of stay (2.3 vs. 3.4 days, p<0.01). There was no difference in the radiation dose from intraoperative fluoroscopy or lengths of procedure between the two cohorts. CONCLUSIONS: Obtaining an intraoperative portable CT scan during PCNL can offer substantial benefits to both patients and surgeons, such as lower reintervention rate, fewer complications, reduced radiation dose to the patient, and shorter length of stay. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e922-e922 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Parth Patel More articles by this author Alexander Kandabarow More articles by this author Eric Chuang More articles by this author Kevin McKenzie More articles by this author Aleksader Druck More articles by this author Christopher Seffren More articles by this author Edward Capoccia More articles by this author Ahmer Farooq More articles by this author Jeffrey Branch More articles by this author Thomas Turk More articles by this author Kristin Baldea More articles by this author Expand All Advertisement Loading ...