Percutaneous Nephrolithotripsy (Pcnl) in Supine Position: Our Experience

Frattini, Antonio; Salsi, P.; Ferretti, Stefano; Ciuffreda, Matteo; Cortellini, P.

doi:10.1016/s1569-9056(06)60355-2

Cited by 5 publications

(6 citation statements)

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“…All patients were stable clinically with no requirement of blood transfusions. To prevent recurrence and to preserve renal function, it is crucial to correct any underlying metabolic or anatomical abnormalities [10,11].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

et al. 2021

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Background To evaluate the safety, feasibility of mini-percutaneous nephrolithotomy (mPCNL) being carried out as a daycare surgery and to study the re-admission, stone clearance rate and complication rates following mPCNL. We also sought to find out the rate of requirement of ancillary procedure, after mPCNL. Methods In this prospective observational study, easily accessible patients above 18 years of age with renal and/or upper ureteric calculi, who underwent mPCNL between September 2018 and February 2020, were included. Seventy patients were selected, as per statistical methods. Preoperative evaluation including history, blood and urine investigations and radiological images was collected. Intra-operative and post-operative events were analyzed. Written consent was obtained from the patients to participate in the study and to publish their data. Institutional Ethical and scientific committee clearance was obtained. Results Out of 70 patients who underwent mPCNL in the study, in the age group ranging from 24–68 years, most of the cases were partial staghorn with maximum size of stone up to about 3.5 cm. Inferior calyx was most frequently punctured. Six cases had multipuncture mPCNL, four patients had bilateral procedure, and two had supra-costal puncture. Eighteen patients had tubeless mPCNL, of which four were totally tubeless procedures. Four patients had hematuria, none requiring transfusion. Two patients had sepsis, managed with higher antibiotics. Limitation of the study was the sample size. To derive a sturdy conclusion, large scale studies are recommended. Conclusions We can conclude that mPCNL can be safely done as daycare or ambulatory surgery in properly selected patients. In centers with experienced urologists, bilateral and multipuncture mPCNL can be done as an ambulatory surgery. Thus, this addresses the stone disease as well as cost containment, without patient safety being compromised. Bed occupancy rate is reduced, helping effective utilization of hospital resources.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

et al. 2021

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“…Various safe and effective modifications of patient positioning for PCNL have been proposed, including the prone split‐leg position, which Scarpa et al. used some years ago, the reverse lithotomy position, the lateral decubitus, and the supine positions [7–9,19–25]. In 1987 Valdivia‐Urìa described a PCNL with the patient supine, with a 3‐L serum bag below the flank.…”

Section: Introductionmentioning

confidence: 99%

“…Surgical and anaesthesiological advantages were described, but despite this the technique has not become popular and remains a complementary method. Indeed, few authors subsequently reported their results obtained with patients in this position in their daily clinical practice [4,22–24,26].…”

Section: Introductionmentioning

confidence: 99%

“…Most of the cardiovascular and pulmonary problems due to being prone, i.e. the duration, and the neuroendocrine and pharmacokinetic effects (further enhanced in morbidly obese, kyphotic or debilitated patients), and postoperative visual problems and neurological deficits (such as brachial plexus palsy and myelic lesions causing paraplegia) can be avoided with the patient turned supine [12–22]. There can be minor disadvantages, including postoperative backache, possible lesions of the knee ligaments, or of the radial or ulnar nerves if the lower and upper extremities are not correctly protected and positioned, and respiratory effects deriving from the progressive cranial location of the diaphragm under general anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

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Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access

Ibarluzea,

Scoffone,

Cracco

et al. 2007

BJU International

266

122

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“…24 Unsal et al 25 compared the efficacy of PCNL using adult versus pediatric sized instruments and found it to be safe and efficient except slight increased bleeding with larger tracts. In the study by Fattini et al 26 of 19 PCNL procedures on 15 children aged from 8 months to 16 years with complex renal stones and with the position (prone and supine), 14 patients were stone free without any major complications. It is believed that the use of adult instruments in children with large kidney stones might have a positive impact on SFR, operation time, and fluoroscopy time without increasing the complication rate.…”

Section: Safety and Efficacy Of Percutaneous Nephrolithotomy In Childmentioning

confidence: 97%

Safety and Efficacy of Percutaneous Nephrolithotomy in Children

Dongol

Limbu

2017

J Nepal Health Res Council

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Background: Renal stone disease is a common problem in children in developing countries. Its prevalence in children varies from 5% to 15%. It is suggested that anatomic abnormalities, recurrent urinary tract infections, metabolic disturbances, dietary and environmental factors are the predisposing factors.The aim of this study is to evaluate the safety and efficacy of percutaneous nephrolithotomy in children.Methods: Between May 2012 and Dec 2016, 25 children with renal stone diseases underwent percutaneous nephrolithotomy and were evaluated for stone free rate, complications, blood transfusion rate, sandwich therapy, etc.Results: The mean age of children was 9.3 years (7-15 years) and the mean size of the stone was 20 mm (13-27 mm). The anatomical location of stone was important in terms of stone clearance. Three patients needed blood transfusion. The overall stone free rate was 88% before discharge. Three patients had residual stones and were treated with extracorporeal shockwave lithotripsy. Complications included fever, haematuria, ileus and urine leak. No major complications were noted. There were no significant differences in haemoglobin and creatinine levels before and 12 hours after the surgery.Conclusions: Percutaneous nephrolithotomy (PCNL) can be considered a safe, effective and feasible modality of treatment for children with an average of 2 cm sized renal stones.

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Percutaneous Nephrolithotripsy (Pcnl) in Supine Position: Our Experience

Cited by 5 publications

References 0 publications

Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study

Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access

Safety and Efficacy of Percutaneous Nephrolithotomy in Children

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