Supine versus prone position in percutaneous nephrolithotomy for kidney calculi: a meta-analysis

Wu, Peng; Wang, Li; Wang, Kunjie

doi:10.1007/s11255-010-9801-0

Cited by 109 publications

(86 citation statements)

References 42 publications

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“…Our results (although the series is still relatively small) are encouraging and easily comparable with published series on prone position, Valdivia, complete supine and the Barts modified Valdivia positions [6,7,8,9,10]. We acknowledge that this type of comparison is subject to a number of biases and in order to properly compare these positions, randomised studies are necessary.…”

Section: Discussionsupporting

confidence: 84%

“…Two recent meta-analyses have shown that supine PCNL is as effective as prone PCNL when comparing stone-free rates, transfusion, complications as well as being significantly quicker [9,10]. Although a variety of supine positions are described including complete supine [6], Valdivia [5], Galdakao modified Valdivia [7] and the Barts modified Valdivia position [8], there does not appear to be any consensus as to which is the ideal supine position.…”

Section: Introductionmentioning

confidence: 99%

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The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

Bach

Goyal²,

Kumar³

et al. 2012

Urol Int

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Background: The last decade has seen the emergence of a variety of supine positions for carrying out percutaneous nephrolithotomy (PCNL). These positions all differ with regard to ease of puncture under image guidance, operative field availability, ability to make and dilate multiple tracts and ease of combining retrograde intrarenal surgery (RIRS). As all of these positions have their limitations regarding the important parameters mentioned above, there is a need for a supine position which addresses some of the difficulties. Methods: We describe and illustrate our flank-free modified supine position, which we believe addresses a number of the issues. Results: Our position allows easy percutaneous access under fluoroscopy (torso only tilted to around 15°), space for placing (flank free of support) and dilating multiple tracts (kidney lies in a fairly neutral position and hence less mobile), a fairly horizontal tract allowing low intrarenal pressures and easy washout of fragments as well as allowing RIRS in a position of relative familiarity. The lesser torso rotation compared with the Valdivia, Galdakao modified and the Barts modified Valdivia positions also means it is more comfortable for patients. Conclusions: Our results are encouraging and easily comparable with published series on prone position, Valdivia, complete supine and the Barts modified Valdivia positions. We would like to highlight the Barts ‘flank-free’ modified supine position as one of the standard positions for carrying out supine PCNL.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

Bach

Goyal²,

Kumar³

et al. 2012

Urol Int

View full text Add to dashboard Cite

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“…They can block urine and cause renal infections, injury, and pain when they move around the body [71, 72]. A study was done to investigate the effects of TQ on ethylene glycol-induced renal calculi in rats.…”

Section: Resultsmentioning

confidence: 99%

An Overview on Renoprotective Effects of Thymoquinone

et al. 2018

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Background: Kidneys as vital organs remove waste material from blood. Additionally, they may also have a role in the electrolyte balance, regulation of blood pressure, and red blood cell genesis. Kidney diseases may be caused by several factors such as ischemia/reperfusion injury, diabetes, and nephrotoxic agents. Oxidative stress and inflammation are involved in the pathogenesis and progression of kidney diseases. Traditionally, natural antioxidants are used for treatment of renal failure in various countries. Summary: People usually select natural antioxidants since they have an opinion that herbal medicine has not any important side effects. Nigella sativa is a flavoring herb that is widely used as a condiment and as a remedy for many disorders. Thymoquinone (TQ), the most important component of black seeds, mainly oil, is considered as an active agent responsible for a lot of the seed’s useful effects. This review describes the protective roles and related mechanisms of TQ against renal disorders. The search terms, including TQ, antioxidant, renal ischemia-reperfusion, diabetic nephropathy, and nephrotoxic agent were searched in scientific databases. TQ showed anti-inflammatory and antioxidant properties in animal and in vitro models of several renal diseases caused by inflammation and oxidative stress. Key Messages: Experimental studies have shown beneficial effects of TQ against renal diseases; however, well-designed clinical trials in humans are required to confirm these effects.

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“…The classical positions for the PCNL patient are the flat prone and deflected prone position. Other modified positions are oblique prone position, oblique supine position and flat supine position [10,11] . Although a number of potential advantages have been described for the supine over the prone position, the prone position still represents the standard for percutaneous access to the kidney, and other positions should be supplementary to this position.…”

Section: Risk Factors For Hemorrhagementioning

confidence: 99%

Post-Percutaneous Nephrolithotomy Septic Shock and Severe Hemorrhage: A Study of Risk Factors

Wang

Jiang²,

Hou³

et al. 2012

Urol Int

103

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Objective: To identify the risk factors predicting septic shock and severe hemorrhage in percutaneous nephrolithotomy (PCNL). Methods: We retrospectively analyzed 420 renal calculi patients who underwent ultrasound-guided PCNL from March 2005 to May 2011. Data on patients who experienced infectious shock requiring anti-shock therapy and severe renal bleeding requiring angiographic renal embolization or nephrectomy were compared with other patients using univariate analyses. Results: Of 420 patients, 10 (2.4%) suffered septic shock and 4 (1%) had severe hemorrhage. The two significant risk factors for infectious shock were preoperative urine white blood cell count and operation time. For severe bleeding the absence of hydronephrosis and puncture time were significant risk factors. Operation time >90 min was associated with both septic shock and severe renal bleeding (p = 0.017). In contrast, the risk of encountering severe renal bleeding was higher if a nephroscope rather than a ureteroscope was used (p = 0.045). Conclusions: Operation time was a risk factor for both septic shock and severe hemorrhage. The patients without hydronephrosis before operation were more likely to suffer severe renal bleeding. Reducing intraoperative puncture time can reduce the probability of severe post-PCNL hemorrhage. The use of a comparatively gross nephroscope passage was likely to result in severe renal bleeding.

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Supine versus prone position in percutaneous nephrolithotomy for kidney calculi: a meta-analysis

Abstract: For general patients with kidney calculi, PCNL in supine position has similar stone-free rate compared with prone. Supine PCNL do not increase related complications. The operative times significantly decrease in supine position.

Cited by 109 publications

References 42 publications

The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

The Barts ‘Flank-Free’ Modified Supine Position for Percutaneous Nephrolithotomy

An Overview on Renoprotective Effects of Thymoquinone

Post-Percutaneous Nephrolithotomy Septic Shock and Severe Hemorrhage: A Study of Risk Factors

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