Document Detail


Does the X-ray Technologist or the Fluoroscopy Time Affect Treatment Success with Shockwave Lithotripsy?
MedLine Citation:
PMID:  22316287     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction and Objective: The minimally invasive nature and effectiveness of shockwave lithotripsy (SWL) has made it one of the primary treatment modalities for urinary tract calculi. Several factors determining the success of SWL treatment have been studied including stone factors (i.e., location, size, and composition) and patient factors (i.e., patient habitus and skin-to-stone distance). Our objective was to determine if either the assisting x-ray technologist or the amount of fluoroscopy time used has an impact on SWL success. Methods: We compared the outcome of 536 SWL treatments across three x-ray technologists. We also evaluated the average amount of fluoroscopy time used in treatment success versus failures in this same cohort. The outcomes measured were stone free and successful fragmentation rate at 2 weeks and 3 months. Successful fragmentation was defined as being either stone free, having residual sand or an asymptomatic fragment ≤4mm on KUB x-ray. Results: The patients treated by the three different x-ray technologists were comparable with respect to BMI, stone side and location, presence of ureteric stent and mean stone area (mm2). The stone free and successful fragmentation rate at 2 weeks and 3 months between the three x-ray technologists were not significantly different. When examining fluoroscopy time, we found a significantly greater mean fluoroscopy time was used in treatments with successful fragmentation at 2 weeks (3.16 min vs. 2.72 min, p=0.0001) and 3 months (3.12 min vs. 2.75 min, p=0.0015) compared to treatment failures. Conclusion: The x-ray technologist did not have a significant impact on SWL treatment outcome at 2 weeks and 3 months. However, successful SWL fragmentation at 2 weeks and 3 months was associated with a greater amount of fluoroscopy time suggesting using fluoroscopy to ensure accurate targeting during SWL is important for successful fragmentation.
Authors:
Michael Ordon; Daniela Ghiculete; Kenneth T Pace; R John John D'A Honey
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-8
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Toronto, Ontario, Canada; michael.ordon@utoronto.ca.
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