Objectives: To compare operative time, safety, and effectiveness of per- cutaneous nephrolithotomy in the supine versus prone position in a prospective randomized trial. Material and methods: From October 2005 to June 2007, 75 patients (33 men, 42 women; mean age, 39.3 yr) were prospectively enrolled and randomly divided into group A (39 patients, supine position) and group B (36 patients, prone position). Inclusion criteria were diagnosis of single or multiple renal stones (pelvic-caliceal) treatable with a single percuta- neous access, stone diameter >2.5 cm, body mass index (BMI) <30 kg/m2, and no contraindications to perform the operation in the prone position. Exclusion criteria were stones in more than one calyx, complete stag- horn stones, and coexisting renal anomalies. Results: The two groups were comparable in age, BMI, male-to-female ratio, and stone size. No significant difference was ascertained between the two groups in terms of stone-free rate (group A, 88.7% vs. group B, 91.6%, p = 0.12), mean blood loss (group A, D hemoglobin 2.3 g/dl vs. group B, 2.2 g/dl, p = 0.23), and mean hospital stay (group A, 4.3 d vs. group B, 4.1 d, p = 0.18). The only significant difference reported was mean operative time (group A, 43 min vs. group B, 68 min, p < 0.001). No blood transfusions were needed and no organ injuries were reported. Conclusions: In this carefully selected patient population with uncom- plicated renal stones, the supine position was similar to the prone position for percutaneous stone removal.

Modified Supine versus Prone Position in Percutaneous Nephrolithotomy for Renal Stones Treatable with a Single Percutaneous Access: A Prospective Randomized Trial

DAMIANO R;
2008-01-01

Abstract

Objectives: To compare operative time, safety, and effectiveness of per- cutaneous nephrolithotomy in the supine versus prone position in a prospective randomized trial. Material and methods: From October 2005 to June 2007, 75 patients (33 men, 42 women; mean age, 39.3 yr) were prospectively enrolled and randomly divided into group A (39 patients, supine position) and group B (36 patients, prone position). Inclusion criteria were diagnosis of single or multiple renal stones (pelvic-caliceal) treatable with a single percuta- neous access, stone diameter >2.5 cm, body mass index (BMI) <30 kg/m2, and no contraindications to perform the operation in the prone position. Exclusion criteria were stones in more than one calyx, complete stag- horn stones, and coexisting renal anomalies. Results: The two groups were comparable in age, BMI, male-to-female ratio, and stone size. No significant difference was ascertained between the two groups in terms of stone-free rate (group A, 88.7% vs. group B, 91.6%, p = 0.12), mean blood loss (group A, D hemoglobin 2.3 g/dl vs. group B, 2.2 g/dl, p = 0.23), and mean hospital stay (group A, 4.3 d vs. group B, 4.1 d, p = 0.18). The only significant difference reported was mean operative time (group A, 43 min vs. group B, 68 min, p < 0.001). No blood transfusions were needed and no organ injuries were reported. Conclusions: In this carefully selected patient population with uncom- plicated renal stones, the supine position was similar to the prone position for percutaneous stone removal.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12317/8114
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