Prospective observational analysis of intraoperative radiation exposure with a mini C-arm intensifier in percutaneous forefoot surgery - 29/11/23
, Victor Housset b, Pierre Alban Bouché c, Alexandre Hardy d, Thomas Bauer b
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Abstract |
Introduction |
Percutaneous forefoot surgery has been associated with higher radiation exposure than the conventional approach. However, there is little data on forefoot surgery using a mini C-arm intensifier. We, therefore, conducted a prospective study to (1) evaluate the intraoperative radiation received by the surgeon during percutaneous forefoot surgery with a mini C-arm; (2) compare the radiation received by the surgeon with the guidelines for occupational exposure issued by the International Commission on Radiological Protection (ICRP) (20 millisieverts per year [mSv/year] for the whole body, 500mSv/year for the hands, and 20mSv/year for the lens of the eye); and (3) compare the radiation received during percutaneous forefoot surgery with that of the open approach, which has already been reported in the literature.
Hypothesis |
The radiation received by the surgeon during percutaneous forefoot surgery with a mini C-arm is lower than the ICRP guidelines, and the findings reported in the literature.
Materials and methods |
This prospective single-center study was conducted from September 2020 to May 2021. A total of 639 feet (i.e., 435 patients) were included. Of these 639 feet, 336 (52%) were hallux valgus repairs, 49 (8%) were stand-alone procedures of the lateral rays, and 124 (19%) were a combination of both. The radiation dose data was retrieved from the mini C-arm daily: dose-area product (DAP) in centigray per square centimeter (cGy/cm2) and radiation exposure duration in seconds. The doses received by the surgeon were collected every month by 4 passive dosimeters (hand, eye lens, and chest [on and under the lead apron]) and 2 active dosimeters (on and under the lead apron).
Results |
The DAP emitted by the mini C-arm during an operating day was 0.10±0.01cGy/cm2 (range, 0.0–3.9), and the mean daily radiation duration was 34.7±19.3seconds (range, 0.7–226.8). There was a mean of 8±8 (range, 1–18) elective procedures per operating day. The daily reading on the active dosimeter worn on the lead apron was 0.002±0 microSv (range, 0–0.04), while the one worn under the apron was 0.001±0 microSv (range, 0–0.03). The equivalent doses over the 7-month study period for the hand, eye lens, and chest (over and under the apron) were 0.14mSv, 0mSv, 0.22mSv, and 0mSv, respectively.
Discussion/Conclusion |
The radiation exposure in percutaneous forefoot surgery with a mini C-arm intensifier observed in our study was lower than the ICRP recommendations and literature findings during open surgery.
Level of evidence |
IV; prospective study without a control group.
El texto completo de este artículo está disponible en PDF.Keywords : Foot, Percutaneous, Minimally invasive, Radiation, International Commission on Radiological Protection (ICRP)
Esquema
Vol 109 - N° 8
Artículo 103705- décembre 2023 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.