Supine PCNL in autosomal dominant polycystic kidney disease

Abstract

Aims and objectives: Standard percutaneous nephrolithotomy (PCNL) has routinely been performed in prone position in autosomal dominant polycystic kidney disease (ADPKD) with nephrolithiasis. The objectives of our present study is to ensure optimum access to the renal collecting system, reducing operative time, and anesthetic morbidity during supine PCNL in ADPKD with nephrolithiasis. Methods: Seven patients were selected randomly. There were no preference for age, gender, size, location and laterality of stone, or BMI . All the patients fit into the AUA guideline criteria for management by percutaneous nephrolithotomy. Preoperative, perioperative, and follow up data were collected prospectively. Results: Seven patients underwent supine PCNL in approximately 2.5 year in modified supine position. There was no intraoperative, post operative, or on follow up complications in any patient. In all the patients stones were cleared completely in single sitting. Conclusions: Supine PCNL in ADPKD with nephrolithiasis is an alternative with similar outcomes to the standard prone PCNL. It provides an additional benefit of performing the procedure in a single position, which is known to reduce total operating time, less anesthesia related complications, less neuromusculoskeletal injury, and reduce physical strain on operating

Supine Percutaneous Nephrolithotomy Under Spinal Anaesthesia: Our Experience Of 365 Cases

“…Supine posture in PCNL is proclaimed safe and effective in the literature 13,14 . Supine PCNL lowers total operating time, anesthesia-related issues, neuromusculoskeletal injury, and physical stress on OR staffduring the procedure 15 . General anesthesia may be challenging in some circumstances like PCNL for staghorn stones because of the possibility of electrolyte imbalance and fluid absorption 16 ; hence spinal anesthesia is a safe alternative in such cases.…”