Implementation of supine percutaneous nephrolithotomy: a novel position for an old operation.

Content Provider	Europe PMC
Author	Sofer, Mario Tavdi, Eli Levi, Oleg Mintz, Ishay Bar-Yosef, Yuval Sidi, Ami Matzkin, Haim Tsivian, Alexander
Copyright Year	2017
Abstract	IntroductionSupine percutaneous nephrolithotomy (PCNL) has become increasingly widespread during the last 2 decades.The aim of this study was to analyze the transition from prone to mainly supine PCNL in 2 endourologic centers.Material and methodsWe retrospectively analyzed data on 214 consecutive supine PCNLs divided into the first (2011–2013) and last (2014–2016) 3 years of this study. The first 27 cases were also included in a randomized controlled trial (RCT) by comparison with 24 prone PCNLs. We compared the clinical outcome and implementation rate. The surgical team was surveyed for their overall impression of performing supine PCNLs.ResultsThe RCT revealed a trend toward shorter operative time (138 vs. 150 minutes), anesthesia time (174 vs. 192 minutes) and hospitalization (2.2 vs. 2.6 days) in the supine PCNL group, without statistical significance and similar stone free rates (SFR) as for the prone PCNL group. Implementation of the supine PCNL reached 96% in 3 years. There was a decrease in operative time (110 vs. 154 minutes; P <0.0001), hospital stay (1.5 vs. 2.1 days; P <0.01), blood transfusion (5% vs. 14%; P <0.05) and rate of ancillary procedures (5% vs. 16%; P <0.05) in the last 3 years of the study. SFR remained stable. Both the surgeons and anesthesiologists expressed their unanimous preference for the supine position over the prone position.ConclusionsSupine PCNLs are easy to implement without a significant learning curve for an experienced endourologist. They can be employed in complex cases and improve surgeon's ergonomics and anesthesiologist's access to the patient.
ISSN	20804806
Journal	Central European Journal of Urology
Volume Number	70
PubMed Central reference number	PMC5407342
Issue Number	1
PubMed reference number	28461990
e-ISSN	20804873
DOI	10.5173/ceju.2017.1222
Language	English
Publisher	Polish Urological Association
Publisher Date	2017-03-14
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. Copyright by Polish Urological Association
Subject Keyword	calculi supine percutaneous nephrolithotomy (PCNL) supine
Content Type	Text
Resource Type	Article
Subject	Urology