Supine PCNL is the Way Forward, with Reduced Anesthesia and Operative Times As Compared to Prone PCNL, Along with Comparable Blood Loss and Stone Free Rates/Supin PCNL ile Karsilastirildiginda, Supin PCNL, Anestezi ve Operasyon Sureleri Azaltilarak Ileriye Dogru Ilerliyor

• Published in: Journal of urological surgery 2019-03, Vol.6 (1), p.1
• Main Authors: Awan, Adnan Siddiq, Khalid, Salman, Khan, Shariq Anis, Mithani, Shoaib, Shaikh, Jahanzeb, Sharif, Imran
• Format: Article
• Language: English
• Subjects: Analysis; Anesthesia; Blood transfusion; Body mass index; Comparative analysis; Glycosylated hemoglobin; Hemoglobins; Lithotripsy; Medical research; Methods; Percutaneous nephrostomy; Safety and security measures; Treatment outcome
• ISSN: 2148-9580; 2148-9580
• DOI: 10.4274/jus.galenos.2018.2032

Objective: The aim of this study is to compare safety and efficacy of supine versus prone percutaneous nephrolithotomy (PCNL) in terms of stone-free rate, operative time, anesthesia time and blood loss in a retrospective case-control trial. Materials and Methods: Fifty patients underwent supine PCNL during the study period (group A). Equal number of patients, who underwent prone PCNL during same period with similar demographic and clinical attributes, were taken as controls (group B). Demographic details, such as gender and age, and body mass index, stone size, stone location and stone laterality were comparable between the two groups. Pre- and post-operative hemoglobin (Hb) levels in patients in both groups were tabulated. Variables analyzed to compare the groups included operative time, anesthesia time, fall in Hb, blood transfusion, stone clearance and need for auxiliary procedure. Results: The median operative time (minutes) in patients of group A [35; interquartile ratio (IQR): 25], was significantly different from group B (70; IQR: 40) (p=0.000). The median anesthesia time (minutes) in patients in group A (50; IQR: 25) was significantly different from group B (85; 45) (p=0.000). The median fall in Hb (g/dL) in patients in group A (1.700; IQR: 1.2) was significantly different from group B (1.200; IQR: 2.4) (p=0.967). Two patients in group A and 7 in group B needed blood transfusion (p=0.080). Thirty two patient in group A and 34 in group B achieved stone-free status (p=0.833). Eleven patients in group A and 6 in group B needed auxiliary procedure in the form of extracorporeal shockwave lithotripsy (p=0.287). Conclusion: Supine PCNL is as safe and effective as conventionally performed prone PCNL, with an added benefit of decreased operative and anesthesia time. Keywords: PCNL, Supine, Prone, Valdivia Amac: Bu calismanin amaci retrospektif bir olgu kontrol calismasinda supin perkutan nefrolitotomi (PCNL) ve pron PCNL'yi tassizlik orani, operasyon suresi, anestezi suresi ve kan kaybi bakimindan karsilastirmaktir. Gerec ve Yontem: Calisma suresince 22 hastaya supin PCNL yapildi (grup A). Ayni donemde benzer demografik ve klinik ozellikleri olan ve pron pozisyonda PCNL uygulanan esit sayida hasta kontrol grubu (grup B) olarak calismaya dahil edildi. Iki grup arasinda cinsiyet, yas, vucut kitle indeksi, tas boyutu, tas yeri ve tas lateralitesi gibi demografik detaylar benzerdi. Her iki gruptaki hastalarin ameliyat oncesi ve sonrasi hemoglobin (Hb) duzeyleri