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Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones

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Abstract

Introduction

Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases.

Patients and methods

Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups.

Results

The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively (p = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group.

Conclusions

PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.

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Authors and Affiliations

  1. Department of Urology, Ankara University School of Medicine, Ankara, Turkey

    Mehmet İlker Gökce, Arif Ibiş, Adem Sancı, Aykut Akıncı, Uygar Bağcı, Eylül Asya Ağaoğlu, Evren Süer & Ömer Gülpınar

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  1. Mehmet İlker Gökce
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  2. Arif Ibiş
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  3. Adem Sancı
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  4. Aykut Akıncı
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  5. Uygar Bağcı
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  6. Eylül Asya Ağaoğlu
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  7. Evren Süer
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  8. Ömer Gülpınar
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Correspondence to Mehmet İlker Gökce.

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This study has no source of funding.

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None of the authors have any conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Gökce, M.İ., Ibiş, A., Sancı, A. et al. Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones. Urolithiasis 45, 603–608 (2017). https://doi.org/10.1007/s00240-017-0977-y

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  • DOI: https://doi.org/10.1007/s00240-017-0977-y

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