Percutaneous nephrolithotomy in prone and supine, which technique is better?: comparative study

Percutaneous nephrolithotomy in prone and supine, which technique is better?: comparative study

Ricardo Contreras-García 1 , Jeffer D. Álvarez-Villarraga 1 , Mariana Saavedra-Castrillón 2, Jorge E. Palacios-Riascos 3, Daniel Díaz-Cardona 2, Héctor A. Ramírez-Vásquez 2

1 Departamento de Urología, Clínica DESA, Cali, Colombia; 2 Departamento de Urología, Clínica Nueva Rafael Uribe, Universidad Libre Seccional Cali, Cali, Colombia; 3 Departamento de Urología, Clínica DESA, Universidad Santiago de Cali. Cali, Colombia

*Correspondence: Ricardo Contreras-García. Email: rcontrerasgar@gmail.com

Abstract


Objective: To evaluate the results of percutaneous nephrolithotomy (PNL) in two positions (prone and supine) in a tertiary reference center.

Method: Cross-sectional, analytical study of patients undergoing percutaneous nephrolithotomy between January 2017 and October 2021, in Cali, Colombia. Variables analyzed: stone size (measured in millimeters), age, American Society of Anesthesiologists (ASA score) classification, stone-free rate, hospital stay, need for transfusion, intervention position, operative time and Clavien-Dindo system postoperative complications. The primary outcome was stone-free rate and the secondary outcomes were length of hospital stay, Clavien-Dindo complications, and operative time.

Results: One hundred-fifty were operated on prone and 55 supine. For prone position stone size had an average of 28.1 ± 10.1 mm, by supine position 32.4 ± 12.5 mm. Stone-free rate for prone 63.3% and supine 70.9% (p = 0.31). A length of hospital stay in prone position was 3.4 ± 2.7 days and in the supine position 5.01 ± 5.6 days (p = 0.046). Clavien-Dindo complications ≥ 3 in prone of 2.67% vs. 0% in supine (p = 0.0063). Surgical time increased hospital stay (odds ratio [OR]: 1.48; 95% CI: 1.07-2.06). The main predictors of longer surgical time were the position of the approach (OR: 4.55; 95% CI: 1.75-11.7) and the size of the stone (OR: 1.49; 95% CI: 1.09-2.05).

Conclusion: The NLP performance position does not modify the stone-free rate. There was a longer hospital stay in the supine position and a longer operative time without an increase in Clavien-Dindo complications. Surgical time was associated with longer hospital stay and approach position and stone size with longer surgical time.

Keywords: Percutaneous nephrolithotomy; Kidney; Stone; Prone position; Supine position

Contents

English version not available. Please check the Spanish version.

⇄ Versión en Español
DOI not available
Add to Mendeley

Text only available in Spanish.

    PERMANYER

    Mallorca, 310
    08037 Barcelona (España)

    Arquímedes, 190 – Colonia Polanco
    Delegación Miguel Hidalgo
    11560 Ciudad de México (México)

    RECURRING LINKS
    CLOCKSS is a dak archive that ensures the long-term survival of web-based scholary publications, governed by and for its stakeholders.

    This journal adheres to the principles established by the Committee on Publication Ethics

    English versión
    DOI not available

    Editorial times

    The editorial process consists of 6 stages:

    1. Reception of the manuscript (indeterminate, depending on whether the author meets the requirements): its objective is to verify that the manuscript complies with the specifications of these instructions for authors and that the submitted documentation is complete.

    2. Initial editorial review (maximum 5 business days): its objective is to corroborate the relevance, timeliness, originality, and scientific contribution of the manuscript, as well as the methodological and statistical soundness of the study. At this time, it will be submitted to an electronic plagiarism detection system. Derived from this, a rejected opinion may be obtained, or it will be sent for review by peer researchers.

    3. Review by peer researchers (maximum 30 business days): the opinion of at least two experts in the area in question will be obtained, who will evaluate the technical and methodological aspects of the investigation.

    4. Editorial review (maximum 7 business days): its objective is to make a decision based on the opinion of peer reviewers. The opinion can be rejected, major changes, minor changes or accepted. In the case of major or minor changes, it will be submitted again for evaluation by the initial peer reviewers.

    5. Final edition (6 weeks): its objective is the technical and linguistic edition (and translation), layout of galleys, DOI assignment, and correction by the author.

    6. Advanced publication: All manuscripts will be published ahead of print on the journal’s website as soon as they complete the editing process, until they are incorporated into a final issue of the journal.