Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones

Introduction Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results,...

Full description

Saved in:
Bibliographic Details
Published in:Urolithiasis 2017-12, Vol.45 (6), p.603-608
Main Authors: Gökce, Mehmet İlker, Ibiş, Arif, Sancı, Adem, Akıncı, Aykut, Bağcı, Uygar, Ağaoğlu, Eylül Asya, Süer, Evren, Gülpınar, Ömer
Format: Article
Language:English
Subjects:
Adult
Female
Humans
Kidney Calices - surgery
Male
Medical Biochemistry
Medicine
Medicine & Public Health
Middle Aged
Nephrolithotomy, Percutaneous - adverse effects
Nephrolithotomy, Percutaneous - methods
Nephrology
Operative Time
Original Paper
Patient Positioning - methods
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Prone Position
Prospective Studies
Staghorn Calculi
Supine Position
Treatment Outcome
Urology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases. Patients and methods Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups. Results The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively ( p  = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group. Conclusions PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.
ISSN:2194-7228
2194-7236
DOI:10.1007/s00240-017-0977-y