Free-flank modified supine vs. prone position in percutaneous nephrolithotomy: A prospective randomised trial

Abdel-Mohsen, Essam; Kamel, Mostafa; Zayed, Abdel-Latif; Salem, Emad A.; Ebrahim, Ehab; Wahab, Khalid Abdel; Elaymen, Ahmed; Shaheen, Adel; Kamel, H.

doi:10.1016/j.aju.2012.11.002

Cited by 15 publications

(4 citation statements)

References 20 publications

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“…Abdel-Mohsen et al, [30] in contrast to our results, compared the technical aspects, operative time, safety and effectiveness of PCNL in the supine position vs. the standard prone position. They found no significant difference between the studied groups as regards fluoroscopy time and patients outcome.…”

Section: Discussioncontrasting

confidence: 67%

Evaluation of Efficacy of Percutaneous Nephrolithotomy in Prone Versus Supine Positions

Homouda

Elbahnasy

Omar

2022

JAMMR

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Aims: To compare between supine and prone percutaneous nephrolithotomy (PCNL) in the management of renal stones regarding stone free rate, operative time and fluoroscopy time. Methodology: A retrospective analysis was performed in the period between January 2019 and January 2021 for patients underwent PCNL for renal stones 2 cm or more. They were 77 patients divided into two groups, group (A) prone 38 patients and group (B) supine 39 patients. Results: the study demonstrated a significant difference in operation time which was (92.5 ± 24.85 min.) in prone group & (68.3 ± 22.90 min.) in supine group with p-value (<0.001), also significant difference in fluoroscopy time which was (258.0 ± 57.19 sec.) in prone group & (166.9 ± 46.60 sec.) in supine group with p-value (<0.001) with shorter operation and fluoroscopy time in the supine than the prone. The study has also demonstrated that there is no statistically significant difference between the two groups as regarding to stone free rate. Conclusion: in patients with renal stones, 2 cm or more, supine PCNL has proved to be superior to prone PCNL as regarding operative and fluoroscopy time but no difference as regards stone free rate. However, Urologists should be familiar with the differences in the positions and be able to use the method appropriate for each patient.

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Section: Discussioncontrasting

confidence: 67%

Evaluation of Efficacy of Percutaneous Nephrolithotomy in Prone Versus Supine Positions

Homouda

Elbahnasy

Omar

2022

JAMMR

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“…The results indicated that our average fluoroscopy time was 271.70 seconds (about 4.5 minutes), with the fastest being 10 seconds and the slowest being 45 minutes. Compared to previous studies that used C-arm support like Mohamed M. Abdallah 11 and Abdel-Mohsen Essam 12 with an average fluoroscopy time of 8.3 and 6.5 minutes respectively, our time was probably faster due to the pre-calculated position and depth of the needle based on CTscan. As a result, both the surgical and radiation exposure times were significantly reduced.…”

Section: Discussionmentioning

confidence: 73%

The Outcome of the Miniaturized Percutaneous Nephrolithotomy in Lateral Position with Guidance of Non-Rotational C-Arm

Pham,

Hoang,

Bui

et al. 2024

RRU

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Objective Evaluation of the outcome of the miniaturized percutaneous nephrolithotomy in the treatment of nephrolithiasis with a lateral position based on the principle of a right triangle under the guidance of a C-Arm without contrast fluid. Materials and Methods Sixty-nine cases of Mini-PCNL with the assistance of a vacuum-assisted sheath in the lateral position were performed at Central Hospital from March 2021 to August 2022. Percutaneous renal access was under the guidance of a non-rotational C-arm without contrast medium, and we determined the puncture location and depth of the needle based on the principle of right triangles. Results The median age was 51.6 ± 12.5 years, and males accounted for 68.1% of the cases. 60.9% of all patients had normal weight. The median stone surface area was 361.1mm2, and 59.4% of all cases were graded as 2 regarding Guy’s stone score. The successful renal access rate was 100%. The tunnel access from the middle and lower calyx accounted for 94.2%. The median access duration, fluoroscopy duration, and hospital length of stay were 271.7 seconds, 14.79 seconds, and 6.3 days, respectively. The complete stone clearance rate was 78.3%. Bleeding complications occurred in 2 patients without mortality. Three patients required an additional procedure. Conclusion The puncture technique into the renal calyxes based on the principle of the right triangle under the guidance of a non-rotational C-Arm without contrast medium in PCNL is a fast, exact, and safe technique.

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“…(2013), who compared the technical aspects, operative time, safety, and effectiveness of PCNL in the supine position versus the standard prone position. [ 10 ] They found no significant difference between the studied groups in fluoroscopy time and patients’ outcome. Ozdemir et al .…”

Section: Discussionmentioning

confidence: 94%

A prospective, randomized comparison of standard prone position versus flank-free modified supine position in percutaneous nephrolithotomy: A single-center initial experience

et al. 2022

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Background: Percutaneous nephrolithotomy (PCNL) is the first choice for treatment of large renal stone >2 cm. The prone position is the classical position preferred by most surgeons. Aiming to improve patient anesthesia and surgery-related inconveniences of the prone position, Valdivia et al ., 1987, described the performance of PCNL with the patient in the supine position. Hence, we aimed to study the safety and efficacy of flank-free modified supine position in PCNL compared to the standard prone position. Patients and Methods: This is a prospective randomized study for 60 patients with large renal stones planned for PCNL operation during the period from November 2017 to May 2019. Patients were divided into two groups (30 patients each group): Group A – patients underwent PCNL in the prone position and Group B – patients underwent PCNL in the modified flank supine position. Patients’ demographics, stone size, Hounsfield unit with intraoperative details as fluoroscopy time, operative time, and complications were recorded. Postoperatively, need for or not to blood transfusions, hospital stay, stone-free status, and postoperative complications were assessed. Results: There was no statistically significant difference between the prone and supine positions regarding stone size (4 cm vs. 4.5 cm, P = 0.16), Hounsfield unit (940 HU vs. 955 HU, P = 0.78), body mass index (31.2 kg/m 2 vs. 32.5 kg/m 2 , P = 0.49), fluoroscopy time (6.9 min vs. 7.3 min, P = 0.5), operative time (89.5 min vs. 90.4 min, P = 0.9), residual stones (10% vs. 20%, P = 0.8), and hospital stay (45.6 h vs. 48.6 h, P = 0.5). Fever occurred in 3.3% of cases in each group and urine leakage observed in one patient with prone position. No blood transfusion was needed in both the groups. Conclusions: PCNL in the modified supine position proved to be a safe and effective choice compared to the prone position for adult patients with large renal calculi.

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Free-flank modified supine vs. prone position in percutaneous nephrolithotomy: A prospective randomised trial

Cited by 15 publications

References 20 publications

Evaluation of Efficacy of Percutaneous Nephrolithotomy in Prone Versus Supine Positions

Evaluation of Efficacy of Percutaneous Nephrolithotomy in Prone Versus Supine Positions

The Outcome of the Miniaturized Percutaneous Nephrolithotomy in Lateral Position with Guidance of Non-Rotational C-Arm

A prospective, randomized comparison of standard prone position versus flank-free modified supine position in percutaneous nephrolithotomy: A single-center initial experience

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