Evidence map›Paper›PMID 36477937›Full record

ArticleUrolithiasis2022

Low-dose fluoroscopy technique drastically decreases patient radiation exposure during percutaneous nephrolithotomy.

Galen Cheng, Timothy Campbell, Changyong Feng, Scott Quarrier, Rajat Jain

Abstract read
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In one paragraph

Article in Urolithiasis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Galen ChengDepartment of Urology, University of Rochester Medical Center, 158 Sawgrass Dr, Floor 2, Rochester, NY, 14620-4648, USA.ORCID http://orcid.org/0000-0002-0019-7080
Timothy CampbellDepartment of Urology, University of Rochester Medical Center, 158 Sawgrass Dr, Floor 2, Rochester, NY, 14620-4648, USA.ORCID http://orcid.org/0000-0001-6220-2538
Changyong FengDepartment of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, 14620, USA.
Scott QuarrierDepartment of Urology, University of Rochester Medical Center, 158 Sawgrass Dr, Floor 2, Rochester, NY, 14620-4648, USA.ORCID http://orcid.org/0000-0002-2546-5264
Rajat JainDepartment of Urology, University of Rochester Medical Center, 158 Sawgrass Dr, Floor 2, Rochester, NY, 14620-4648, USA. Rajat_Jain@urmc.rochester.edu.ORCID http://orcid.org/0000-0003-0453-5574

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fluoroscopy is essential in percutaneous nephrolithotomy (PCNL) but exposes patients and operating room staff to radiation. We investigated whether a low-dose (LD) protocol could reduce radiation exposure during fluoroscopy-guided access without compromising clinical outcomes. Patients undergoing PCNL with fluoroscopy-guided access at a tertiary care stone center between January 2019 and July 2021 were identified. Prior to September 3, 2020, the Philips Veradius C-arm's default settings were used: standard per-frame dose, 15 pulses per second (PPS) frame rate. After this date, a low-dose protocol was used: reduced per-frame dose, reduced frame rate of 8 PPS for needle puncture and 4 PPS for all other steps. Clinical and radiographical data were retrospectively collected. The primary outcome was cumulative radiation dose. Secondary outcomes were stone-free status (SFS; defined as no fragments ≥ 2 mm) and complications. Multivariate regression analysis was performed. 100 patients were identified; 31 were in the LD group. The LD cohort was exposed to a significantly lower mean cumulative radiation dose of 11.68 mGy compared to 48.88 mGy (p < 0.0001). There were no differences in operative time, fluoroscopy time, stone burden, SFS, or complications. In a multivariable regression model adjusting for several variables, LD protocol was associated with lower radiation dose while skin-to-calyx-distance (STCD) was positively associated with cumulative radiation dose. Low-dose fluoroscopy and decreased frame rate during PCNL decreased radiation exposure fourfold without affecting SFS or complication rates.

Indexed as

Nephrolithotomy, PercutaneousRadiation ExposureHumansRetrospective StudiesFluoroscopyPercutaneous nephrolithotomyQuality assuranceRadiation dosage

Identifiers

PMID36477937

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.