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Prone versus modified supine position in percutaneous nephrolithotomy: a prospective randomized study.

Wang Y, Wang Y, Yao Y, Xu N, Zhang H, Chen Q, Lu Z, Hu J, Wang X, Lu J, Hao Y, Jiang F, Hou Y, Wang C - Int J Med Sci (2013)

Bottom Line: The rate of second PCNL was significantly higher and the stone clearance rate was significantly lower in the modified supine than in the prone position group.Both the prone and modified supine positions are effective and safe for PCNL.Operation time was longer in the modified supine group, and patients undergoing PCNL in the modified supine position more frequently required a second operation due to a lower stone clearance rate.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Urology, First Hospital of Jilin University, 130021, Changchun, China.

ABSTRACT

Objective: To perform a prospective randomized trial comparing the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the prone and modified supine positions.

Methods: Between August 2010 and August 2011, 102 patients with renal calculi and 20 patients with ureteral calculi were randomized to undergo fluoroscopy and ultrasound-guided PCNL procedures in the prone or modified supine position. Baseline characteristics, puncture position, numbers of punctures, operation time, stone free rate, loss of blood, hospital stay and second phase PCNL were compared in the two groups.

Results: There were no significant differences in gender, age, body mass index, stone location, stone size and the presence of hydronephrosis between the two groups. The rate of second PCNL was significantly higher and the stone clearance rate was significantly lower in the modified supine than in the prone position group. Mean operation time was significantly lower in the prone than in the modified supine position group (78 min vs 88 min, P<0.05). There were no significant differences in rates of rib and calyx puncture, numbers of punctures, mean blood loss, and mean hospital stay between the two groups.

Conclusions: Both the prone and modified supine positions are effective and safe for PCNL. Operation time was longer in the modified supine group, and patients undergoing PCNL in the modified supine position more frequently required a second operation due to a lower stone clearance rate.

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Related in: MedlinePlus

CONSORT flowchart.
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Figure 1: CONSORT flowchart.

Mentions: Patients were included if they had kidney stones of diameter >2.0 cm or upper ureter stones of diameter >1.5 cm and had not previously undergone nephrostomy; and if they did not have serious cardiovascular or cerebrovascular disease or a hemorrhagic tendency. All patients were definitively diagnosed preoperatively by plain film X-rays, intravenous pyelogram, ultrasonography or CT plain scan. All operations were performed by one surgeon, with at least 5 years of experience with PCNL. All patients provided written informed consent, and the study protocol was approved by the institutional review board of the First Hospital of Jilin University. A CONSORT flowchart of this trial is shown in Figure 1.


Prone versus modified supine position in percutaneous nephrolithotomy: a prospective randomized study.

Wang Y, Wang Y, Yao Y, Xu N, Zhang H, Chen Q, Lu Z, Hu J, Wang X, Lu J, Hao Y, Jiang F, Hou Y, Wang C - Int J Med Sci (2013)

CONSORT flowchart.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3775109&req=5

Figure 1: CONSORT flowchart.
Mentions: Patients were included if they had kidney stones of diameter >2.0 cm or upper ureter stones of diameter >1.5 cm and had not previously undergone nephrostomy; and if they did not have serious cardiovascular or cerebrovascular disease or a hemorrhagic tendency. All patients were definitively diagnosed preoperatively by plain film X-rays, intravenous pyelogram, ultrasonography or CT plain scan. All operations were performed by one surgeon, with at least 5 years of experience with PCNL. All patients provided written informed consent, and the study protocol was approved by the institutional review board of the First Hospital of Jilin University. A CONSORT flowchart of this trial is shown in Figure 1.

Bottom Line: The rate of second PCNL was significantly higher and the stone clearance rate was significantly lower in the modified supine than in the prone position group.Both the prone and modified supine positions are effective and safe for PCNL.Operation time was longer in the modified supine group, and patients undergoing PCNL in the modified supine position more frequently required a second operation due to a lower stone clearance rate.

View Article: PubMed Central - PubMed

Affiliation: 1. Department of Urology, First Hospital of Jilin University, 130021, Changchun, China.

ABSTRACT

Objective: To perform a prospective randomized trial comparing the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the prone and modified supine positions.

Methods: Between August 2010 and August 2011, 102 patients with renal calculi and 20 patients with ureteral calculi were randomized to undergo fluoroscopy and ultrasound-guided PCNL procedures in the prone or modified supine position. Baseline characteristics, puncture position, numbers of punctures, operation time, stone free rate, loss of blood, hospital stay and second phase PCNL were compared in the two groups.

Results: There were no significant differences in gender, age, body mass index, stone location, stone size and the presence of hydronephrosis between the two groups. The rate of second PCNL was significantly higher and the stone clearance rate was significantly lower in the modified supine than in the prone position group. Mean operation time was significantly lower in the prone than in the modified supine position group (78 min vs 88 min, P<0.05). There were no significant differences in rates of rib and calyx puncture, numbers of punctures, mean blood loss, and mean hospital stay between the two groups.

Conclusions: Both the prone and modified supine positions are effective and safe for PCNL. Operation time was longer in the modified supine group, and patients undergoing PCNL in the modified supine position more frequently required a second operation due to a lower stone clearance rate.

Show MeSH
Related in: MedlinePlus