A study on comparative outcomes of percutaneous nephrolithotomy in prone, supine, and flank positions

Karami, Hossein; Mohammadi, Reza; Lotfi, Behzad

doi:10.1007/s00345-012-0889-y

Cited by 57 publications

(31 citation statements)

References 21 publications

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“…De Sio et al14 reported that in their randomized controlled study, the stone-free rate was excellent in both the supine (88.7%) and the prone (91.6%) position PCNL groups. Shoma et al16 reported similar success rates for the supine (89%) and prone (84%) positions in a prospective nonrandomized study, and Karami et al15 reported that the success rate was 92% in the prone position, 86% in the supine position, and 88% in the lateral position.…”

Section: Discussionmentioning

confidence: 86%

Feasibility and Efficacy of Intermediate-Supine Percutaneous Nephrolithotomy: Initial Experience

et al. 2014

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We evaluated the feasibility and efficacy of intermediate-supine percutaneous nephrolithotomy (PCNL) in patients with renal calculi. Fifteen patients were included in this study. The intermediate-supine operative position was modified by using a 1-L saline bag below the ipsilateral upper flank. A nephrostomy and stone extraction were performed as usual. After completion of the stone removal, a nephrostomy tube was used when necessary according to the surgeon's decision. If there was no significant bleeding or renal pelvic injury, tubeless PCNL was performed. The mean stone size was 5.48±5.69 cm2, the mean operative time was 78.93±38.72 minutes, and the mean hospital stay was 2.60±1.29 days. Tubeless PCNL was performed in 13 cases (86.7%), and retrograde procedures were simultaneously performed without a change of position in 2 patients (ureteroscopic ureterolithotomy in one patient and transurethral placement of an occlusion catheter in one patient). There were two complications according to the Clavien-Dindo classification (Grade I in one patient and Grade II in one patient). The success rate was 80.0% and the complete stone-free rate was 73.3%. Three patients with a significant remnant stone were also successfully managed with additional procedures (one patient underwent a second-look operation, and the remaining two patients were treated with shock wave lithotripsy). In the treatment of renal calculi, intermediate-supine PCNL may be a safe and effective choice that offers several advantages with excellent outcomes. Thus, a prospective study with a larger population is needed to verify our outcomes.

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Section: Discussionmentioning

confidence: 86%

Feasibility and Efficacy of Intermediate-Supine Percutaneous Nephrolithotomy: Initial Experience

et al. 2014

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“…Since medical imaging assistance to puncture commonly requires approximately 10 min [26][27][28][29], the puncture step itself remains faster than any literature approach, without any radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

Validation of percutaneous puncture trajectory during renal access using 4D ultrasound reconstruction

Rodrigues

Fonseca

et al. 2015

SPIE Proceedings

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Background: An accurate percutaneous puncture is essential for disintegration and removal of renal stones. Although this procedure has proven to be safe, some organs surrounding the renal target might be accidentally perforated. This work describes a new intraoperative framework where tracked surgical tools are superimposed within 4D ultrasound imaging for security assessment of the percutaneous puncture trajectory (PPT). Methods: A PPT is first generated from the skin puncture site towards an anatomical target, using the information retrieved by electromagnetic motion tracking sensors coupled to surgical tools. Then, 2D ultrasound images acquired with a tracked probe are used to reconstruct a 4D ultrasound around the PPT under GPU processing. Volume hole-filling was performed in different processing time intervals by a tri-linear interpolation method. At spaced time intervals, the volume of the anatomical structures was segmented to ascertain if any vital structure is in between PPT and might compromise the surgical success. To enhance the volume visualization of the reconstructed structures, different render transfer functions were used. Results: Real-time US volume reconstruction and rendering with more than 25 frames/s was only possible when rendering only three orthogonal slice views. When using the whole reconstructed volume one achieved 8-15 frames/s. 3 frames/s were reached when one introduce the segmentation and detection if some structure intersected the PPT. Conclusions: The proposed framework creates a virtual and intuitive platform that can be used to identify and validate a PPT to safely and accurately perform the puncture in percutaneous nephrolithotomy.

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“…Karami et al [5] reported a comparative study between prone, supine, and lateral (flank) positions. A total of 150 PCNL candidates either underwent fluoroscopy-guided supine or prone access, or ultrasound-based lateral access.…”

Section: Other Techniquesmentioning

confidence: 99%

“…Since the prone PCNL report by Fernstrom [4,5], reverse lithotomy [6], and modified lateral positions [7]. The prone approach has also been modified, with variations such as the prone-flexed position [8].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous nephrolithotomy

Dasgupta¹,

Patel²

2013

Current Opinion in Urology

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A study on comparative outcomes of percutaneous nephrolithotomy in prone, supine, and flank positions

Cited by 57 publications

References 21 publications

Feasibility and Efficacy of Intermediate-Supine Percutaneous Nephrolithotomy: Initial Experience

Feasibility and Efficacy of Intermediate-Supine Percutaneous Nephrolithotomy: Initial Experience

Validation of percutaneous puncture trajectory during renal access using 4D ultrasound reconstruction

Percutaneous nephrolithotomy

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