Bilgisayarlı tomografi ve floroskopi kılavuzluğunda perkütan nefrostomi işlemlerindeki radyasyon maruziyeti için bir retrospektif kıyaslama

Year 2021, , 166 - 172, 29.05.2021

Yaşar Türk , İsmail Devecioğlu

https://doi.org/10.29058/mjwbs.852206

Abstract

Amaç: Bu çalışmada BT eşliğinde gerçekleştirilen ilk perkütan nefrostomi işleminde ve floroskopi eşliğinde gerçekleştirilen nefrostomi değiştirme işleminde hasta tarafından emilen doz miktarının kıyaslanması amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif çalışmaya nefrostomi işlemine yönlendirilmiş 89 hidronefroz hasta dahil edilmiştir. Bu hastlardan 75’inde BT eşliğinde ilk defa nefrostomi işlemi gerçekleştirilmiştir. 14 hastada ise floroskopi eşliğinde nefrostomi değitirme işlemi yapılmıştır. Bu işlemler sırasında emilen doz miktarları kıyaslanmıştır.
Bulgular: Gruplar demografik (yaş, cinsiyet ve pataloji) ve işlem parametreler (müdahale tarafı ve komplikasyonlar) açısından istatistiksel farklılık göstermemiştir. Ancak emilen radyasyon doz miktarı açısından iki grup arasında istatistiksel farklılık gözlemlenmiştir. Ortanca emilen radyasyon dozu CT grubunda 1.18 mSv iken, floroskopi grubunda 1.68 mSv olarak tespit dilmiştir. İlk kez gerçekleştirilen BT eşliğinde nefrostomi işlemleri, floroskopi eşliğinde gerçekleştirilen nefrostomi değiştirme işlemlerine kıyasla istatistiksel olarak anlamlı bir şekilde daha düşük radyasyon dozu ile tamamlanmıştır (p < 0.001).
Sonuç: Ultra-düşük-doz ve hızlı BT eşliğinde nefrostomi güvenli, kullanımı kolay, hastaya beklenenden daha düşük doz uygulayan bir işlemdir. Farklı belirtiler gösteren geniş bir yaş aralığındaki hastalar için BT kılvuzluğu, düşük komplikasyon oranı ile nefrostomi yerleştirme için floroskopi’ye göre daha iyi bir alternatiftir.

Keywords

Nefrostomi, hidronefroz, bilgisayarlı tomografi, floroskopi, radyasyon dozu

A retrospective comparison of computed tomography and fluoroscopic guided percutaneous nephrostomy for evaluating radiation exposure

Abstract

Objective: The study aimed to compare the radiation doses absorbed by the patient in first-time percutaneous nephrostomy under CT and nephrostomy replacement under fluoroscopy.
Materials and Methods: 89 hydronephrotic patients referred for nephrostomy were included in this retrospective study. 75 of these patients had the nephrostomy for the first-time under CT-guidance. 14 patients had the nephrostomy replacement operation under fluoroscopy guidance. Absorbed radiation doses were compared between these operations.
Results: The groups showed no statistically significant differences in means of demography (age, sex, and pathology) and operational parameters (intervention side and complications) except the absorbed radiation dose. The median effective radiation doses were 1.18 mSv and 1.68 mSv for CT and fluoroscopy, respectively. The first-time nephrostomy operations under CT were completed with radiation doses significantly lower than those in nephrostomy replacement under fluoroscopy (p < 0.001).
Conclusion: Ultra-low-dose and fast-acting CT-guided nephrostomy is a safe, user-friendly procedure that leads patients to less radiation exposure than expected. CT guidance is a better alternative than fluoroscopy in percutaneous nephrostomy placement with a low complication rate in patients with different indications and a wide age interval.

Keywords

Nephrostomy, hydronephrosis, computed tomography, fluoroscopy, radiation dose

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