Is Supine Mini Percutaneous Nephrolithotomy better than Prone Mini Percutaneous Nephrolithotomy: A Single-Center Experience

Abstract

Objective
Miniaturized percutaneous nephrolithotomy (mini-PCNL) is the primary treatment modality in stone management. However,
prone and supine positioning remains a matter of concern because of associated complications and morbidity. The present study
aimed to compare success and complication rates of supine and prone position in patients undergoing mini-PCNL.
Material and Methods
A prospective observational study was conducted in patients (age >18-years) with renal calculi 1-3 cm in size who performed
mini-PCNL between September 2017 and February 2019. The stone size was determined by computed tomography (CT) scan
and kidney, ureter, and bladder X-ray. Post-operative parameters and complications were compared in both the groups. Statistical
significance was defined as p<0.05.
Results
A total of 116 patients were enrolled (52 in the supine mini-PCNL group and 64 patients in the prone mini PCNL groups). The
mean operative time was significantly lower (44.80 mins) in supine mini-PCNL compared to the prone mini-PCNL (53.93 mins)
(p<0.0074). The mean hospital stays in supine and prone mini-PCNL group was 2.06 and 2.51-days, respectively (p=0.01). A
complete stone clearance was observed in supine mini-PCNL group. The incidence of tubeless and totally tubeless procedure was
significantly higher in supine mini-PCNL group (90% and 61%, respectively) (p<0.0001). No difference in terms of complications
is reported between the supine and prone mini-PCNL group.
Conclusion
Supine mini-PCNL and prone mini-PCNL found to be comparable in terms of success rate and complications. However, supine
mini-PCNL can be preferred due to its shorter operative time in the patients with renal stones.