Application of flank suspended supine position in percutaneous nephrolithotomy

Abstract

Objective To investigate the safety and efficacy of percutaneous nephrolithotomy （PCNL） in a new operative position, flank suspended supine position. Methods The new position hold affected flank suspended by raising the ipsilateral shoulder and haunch with two 3 liter saline bags, and set up waist bridge simultaneously. From March 2010 to October 2010, a series of 173 pa- tients underwent PCNL with the new supine position under epidural anesthesia. The average age was （50±11） years, and the average bulk of the stone was （2.9±1.0） era. All patients were placed in the new supine position. Under ultrasound guidance, the desired ealix or pelvis was punctured near the posterior axillary line, then dilating the tract and establishing the 16 F or 20 F tract for PCNL. Resuits The pelvicaliceal system could be successfully approached in all patients. The procedure was well tolerated in all patients. Mean operation time was （86±34） rain. 80. 3% of the patients were rendered free of stones by the initial PCNL. Thirty-four cases had residual stones, and a second PCNL was performed in 16 cases to clear the residual stones. Only 1 patient required blood transfusion. None of the patients suffered visceral injury. Conclusion The new supine position is safe and effee tive for PCNL. Key words: Nephrostomy, pereutaneous; Kidney calculi; Supine position; Ureteral calcult