Prospective Randomized Control Trial of Novel lead-free drape (RADIONEX) for Radiation Protection in Retrograde Intra-Renal Surgery Stone Procedures
Saeed Bin Hamri 1,2, Abdulrahamn Almuhrij 1, Abdulla Alhumam 1, Hussam Alshubaili 1, Abdulaziz Alswaig 1, Abdulbarri Ajajj 1, Mohamed Sammour 1, Ahmed Alasker 1
Urology Department, King Abdulaziz National Guard Hospital, Al-Ahsa, Saudi Arabia 1
PETRA URO-GROUP 2
In Endourology field, Retrograde Intra-Renal Surgery (RIRS) procedures for urinary stone management is associated with significant radiation exposure. It may be significant in high-volume centers. We investigated whether a radiation-attenuating drape (RADIONEX) (Fig1) to reduces Surgeon radiation exposure during any procedure of RIRS.
PATIENTS & METHODS:
We performed a prospective randomized study in RIRS procedures at high volume center. Procedures were randomly assigned to groups receiving (Study Group) lead-free radiation-attenuating drapes (n=54) or (Control Group) (n=48). The drapes were suspended between the leg of the patients (Study Group) during RIRS procedures. The primary end point was the effective dose of radiation measured at the endourologist’s Head (D1), Chest behind the apron (D2), and right leg (D3). The cumulative radiation exposure was also estimated. Statistics analysis was performed through SPSS.
Fluoroscopy time and absorbed radiation dose were similar in both groups. Mean radiation exposure for Control Group vs. radiation-attenuating drape was 48.8±16.77 vs. 51.6±17.08 mGy/cm2. Radiation dose were registered the endourologis’s Head (D1) Control 3.23±3.23 vs. Study 2.24±2.87mSv; at the endourologist’s Chest (D2) Control 0.53±0.83 vs. Study 0.44±0.67 mSv at the leg Control 9.7±13.7 vs. Study 7.5±11 mSv (P>0.05 for all comparisons) with tendency in (D1 P=0.097). The relative risk reduction in radiation was 30%, 20%, and 21% at the three sites. At a high-volume center in which an endourologist performs 100 therapeutic RIRS per year, the estimated cumulative effective dose at the endourologist’s Head, Chest and leg showed no difference using the radiation-attenuating drape (RADIONEX), However, Head (D1) showed more reduction.
The addition of a radiation-attenuating drape (RADIONEX) as radiation protection during RIRS insignificantly decreases radiation exposure to the endourologist by 20-30%. Nevertheless, procedures > 100 should be performed to re-evaluate this Drape.