Is Supine Mini Percutaneous Nephrolithotomy better than Prone Mini Percutaneous Nephrolithotomy: A Single-Center Experience
DOI:
https://doi.org/10.17140/UAOJ-4-130Keywords:
Percutaneous nephrolithotomy, Prone position, Supine position, Stone free rateAbstract
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.
References
Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU guidelines on interventional treatment for urolithiasis. Eur Urol. 2016; 69: 475-482. doi: 10.1016/j.eururo.2015.07.041
Jackman SV, Hedican SP, Peters CA, Docimo SG. Percutaneous nephrolithotomy in infants and preschool age children: Experience with a new technique. Urology. 1998; 52: 697-701. doi: 10.1016/ s0090-4295(98)00315-x
Knoll T, Heger K, Haecker A. Percutaneous nephrolithotomy: experience from 348 procedures. Eur Urol. 2004; 3: 42.
Zeng G, Zhao Z, Wan S, Mai Z, Wu W, Zhong W, et al. Minimally invasive percutaneous nephrolithotomy for simple and complex renal caliceal stones: A comparative analysis of more than 10,000 cases. J Endourol. 2013; 27: 1203-1238. doi: 10.1089/end.2013.0061
Bozzini G, Verze P, Arcaniolo D, Piaz OD, Buffi NM, Guazzoni G, et al. A prospective randomized comparison among SWL, PCNL and RIRS for lower calyceal stones less than 2 cm: A multicenter experience: A better understanding on the treatment options for lower pole stones. World J Urol. 2017; 35: 1967-1975. doi: 10.1007/s00345-017-2084-7
Valdivia Uría JG, LacharesSantamaría E, Villarroya Rodríguez S, et al. Percutaneous nephrolithotomy: Simplified technic (preliminary report). Arch Esp Urol.1987; 40: 177-180.
Yuan D, Liu Y, Rao H, Cheng TF, Sun ZL, Wang YL, et al. Supine versus prone position in percutaneous nephrolithotomy for kidney calculi: A meta-analysis. J Endourol. 2016; 30: 754-763. doi: 10.1089/end.2015.0402
Zhang X, Xia L, Xu T, Wang X, Zhong S, Shen Z. Is the supine position superior to the prone position for percutaneous nephrolithotomy (PCNL)? Urolithiasis. 2014; 42: 87-93. doi: 10.1007/s00240-013-0614-3
Liu L, Zheng S, Xu Y, Wei Q. Systematic review and meta-analysis of percutaneous nephrolithotomy for patients in the supine versus prone position. J Endourol. 2010; 24: 1941-1946. doi:
1089/end.2010.0292 10. Falahatkar S, Mokhtari G, Teimoori M. An Update on supine versus prone percutaneous nephrolithotomy: A meta-analysis. Urol J. 2016; 13: 2814-2822.
Kumar P, Bach C, Kachrilas S, Papatsoris AG, Buchholz N, Masood J. Supine percutaneous nephrolithotomy (PCNL): “In vogue” but in which position? BJU Int. 2012; 110: E1018-E1021. doi: 10.1111/j.1464-410X.2012.11188.x Submit your article to this journal | https://openventio.org/submit-manuscript/ Quadri M et al
Cracco CM, Scoffone CM. ECIRS (endoscopic combined intrarenal surgery) in the Galdakao-modified supine Valdivia position: A new life for percutaneous surgery? World J Urol. 2011; 29: 821-827. doi: 10.1007/s00345-011-0790-0
Tokatlı Z, Gokce MI, Süer E, Sağlam R. Supine or prone position for mini-PNL procedure: does it matter. Urolithiasis. 2015; 43: 261-264. doi: 10.1007/s00240-015-0758-4
Giusti G, Piccinelli A, Taverna G, et al. MiniPerc? No, Thank you! Eur Urol. 2007; 51: 810-814; discussion 815. doi: 10.1016/j. eururo.2006.07.047
Ozdemir H, Erbin A, Sahan M, Savun M, Cubuk A, Yazici O, et al. Comparison of supine and prone miniaturized percutaneous nephrolithotomy in the treatment of lower pole, middle pole and renal pelvic stones: A matched pair analysis. Int Braz J Urol. 2019; 45: 956-964. doi: 10.1590/S1677-5538.IBJU.2019.0049
Zhan HL, Li ZC, Zhou XF, Yang F, Huang J-F, Lu M-H. Supine lithotomy versus prone position in minimally invasive percutaneous nephrolithotomy for upper urinary tract calculi. Urol Int. 2013; 91: 320-325. doi: 10.1159/000351337
Wu P, Wang L, Wang K. Supine versus prone position in percutaneous nephrolithotomy for kidney calculi: Ameta-analysis. Int Urol Nephrol. 2011; 43: 67-77. doi: 10.1007/s11255-010-9801-0
Miano R, Scoffone C, De Nunzio C, Germani S, Cracco C, Usai P, et al. Position: Prone or supine is the issue of percutaneous nephrolithotomy. J Endourol. 2010; 24: 931-938. doi: 10.1089/ end.2009.0571
de la Rosette JJ, Tsakiris P, Ferrandino MN, Elsakka AM, Rioja J, Preminger GM. Beyond prone position in percutaneous nephrolithotomy: A comprehensive review. Eur Urol. 2008; 54: 1262-1269. doi: 10.1016/j.eururo.2008.08.012
Gupta S, Das SK, Pal DK. Total tubeless ultra-mini supine percutaneous nephrolithotomy: A feasibility study. Turk J Urol. 2018; 44: 323-328. doi: 10.5152/tud.2018.48642
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