Bilgisayarlı Tomografi ve Floroskopi Kılavuzluğunda Perkütan Nefrostomi İşlemlerindeki Radyasyon Maruziyeti İçin Bir Retrospektif Kıyaslama

Amaç: Bu çalışmada bilgisayarlı tomografi (BT) eşliğinde gerçekleştirilen ilk perkütan nefrostomi işleminde ve floroskopi eşliğinde gerçekleştirilen nefrostomi değiştirme işleminde hasta tarafından emilen doz miktarının kıyaslanması amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif çalışmaya nefrostomi işlemine yönlendirilmiş 89 hidronefroz hasta dahil edilmiştir. Bu hastalardan 75’inde BT eşliğinde ilk defa nefrostomi işlemi gerçekleştirilmiştir. 14 hastada ise floroskopi eşliğinde nefrostomi değiştirme işlemi yapılmıştır. Bu işlemler sırasında emilen doz miktarları kıyaslanmıştır. Bulgular: Gruplar demografik (yaş, cinsiyet ve pataloji) ve işlem parametreleri (işlem tarafı ve kom- plikasyonlar) açısından istatistiksel farklılık göstermemiştir. Ancak emilen radyasyon doz miktarı açısından iki grup arasında istatistiksel farklılık gözlemlenmiştir. Ortanca emilen radyasyon dozu BT grubunda 1,18 mSv iken, floroskopi grubunda 1,68 mSv olarak tespit edilmiştir. 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.

A Retrospective Comparison of Computed Tomography and Fluoroscopic Guided Percutaneous Nephrostomy for Evaluating Radiation Exposure

Aim: The study aimed to compare the radiation doses absorbed by the patient in first-time percutaneous nephrostomy under computed tomography (CT) and nephrostomy replacement under fluoroscopy. Material and Methods: Eighty-nine hydronephrotic patients referred for nephrostomy were included in this retrospective study. Seventy-five of these patients had the nephrostomy for the first-time under CT- guidance. Fourteen 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.

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