COMPARISON OF THE EFFICACY AND SAFETY OF THE SUPINE AND PRONE POSITIONS IN PERCUTANEOUS NEPHROLITHOTOMIES FOR KIDNEY STONES
DOI:
https://doi.org/10.22159/ijap.2019.v11s6.33545Keywords:
Supine, Prone, Percutaneous, Nephrolithotomy, Kidney, StonesAbstract
Objective: This study was designed to compare the efficacy and safety of the supine and prone positions in percutaneous nephrolithotomies (PCNLs) used for the treatment of kidney stones in Indonesian patients.
Methods: This was a single-blinded randomized controlled trial of those patients undergoing PCNLs from February to May of 2018. There were 19 subjects in the supine group and 19 in the prone group for a total of 38 study subjects. The study outcomes that were compared included the operative time, hospital length of stay (LOS), stone-free rate, blood loss, conversion to open surgery, blood transfusion, and complications. These outcomes were evaluated using the Student’s t test and the chi-squared test.
Results: There were no significant differences in the patient demographics or stone locations between the two groups. Additionally, the medians of the operative times, LOSs, blood losses, and blood transfusions were not statistically different. There was a higher stone-free rate in the supine group than in the prone group (70.0% vs. 47.4%, respectively, p = 0.151). More subjects were transfused in the supine group (30.0%) than in the prone group (15.8%), but this difference was not statistically significant (p = 0.292). The only complications were infundibular lacerations, which occurred in 20% of the subjects in the supine group and 15.8% of the subjects in the prone group (p = 0.732).
Conclusion: This study showed that the supine and prone positions for PCNLs had similar efficacy and safety outcomes.
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2. Pradere B, Doizi S, Protetti S, Brachlow J, Traxer O. Evaluation of guidelines for surgical management of urolithiasis. J Urol 2018;199:1267-71.
3. Ziemba JB, Matlaga BR. Guideline of guidelines: kidney stones. BJU Int 2015;116:184-9.
4. Falahatkar S, Mogghadddam AA, Salehi M, Esmaili F. Complete supine percutaneous nephrolithotripsy comparison with the prone standard technique. J Endourol 2008;22:2513-7.
5. DasGupta R, Patel A. Percutaneous nephrolithotomy: does position matter? prone, supine and variations. Curr Opinion Urol 2013;23:164-8.
6. Patel RM, Okhunov Z, Clayman RV, Landman J. Prone versus supine percutaneous nephrolithotomy: what is your position? Curr Urol Reports 2017;18:26.
7. Mak DK, Smith Y, Buchholz N, El-Husseiny T. What is better in percutaneous nephrolithotomy–prone or supine? A systematic review. Arab J Urol 2016;14:101-7.
8. Yazici CM, Kayhan A, Dogan C. Supine or prone percutaneous nephrolithotomy: do anatomical changes make it worse? Arab J Urol 2018;28:10-6.
9. Ganpule AP, Vijayakumar M, Malpani A, Desai M. Percutaneous nephrolithotomy (PCNL) a critical review. Int J Surgery 2016;36(Pt D):660-4.
10. Jones MN, Ranasinghe W, Cetti R, Newell B, Chu K, Harper M, et al. Modified supine versus prone percutaneous nephrolithotomy: surgical outcome from a tertiary teaching hospital. Investigative Clin Urol 2016;57:268-73.
11. Sohail N, Albodour A, Abdelrahman KM. Percutaneous nephrolithotomy in complete supine flank-free position in comparison to prone position: a single-centre experience. Arab J Urol 2016;15:42-7.
12. Gokce MI, Ibis A, Sanci A, Akinci A, Bagci U, Agaoglu EA, et al. Comparison of supine and prone position for percutaneous nephrolithotomy in treatment of staghorn stones. Urolithiasis 2017;45:603-8.
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