Comparison on efficacy and safety of percutaneous nephrolithotomy for the treatment of renal stones: modified supine Valdivia versus prone position

Abstract

Objective To compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) in modified supine Valdivia and traditional prone positions for the treatment of renal stones. Methods Clinical data of 80 consecutive patients with renal calculi who accepted PCNL from December 2012 to September 2014 were retrospectively reviewed.They were divided into modified supine Valdivia group (n=44) and prone position group (n=36) according to the position during surgery.There was no significant difference between the 2 groups in age, sex, ASA class, stone location and size (P>0.05). Total operative time, ratio of multi-access, blood loss, perioperative complications and stone-free rate were compared between the 2 groups. Results All punctures were performed successfully.No case was converted to open surgery.No severe complications such as colon injury, pleura or peritoneum perforation, or death occurred intra- and post-operatively.In prone position, 1 patient was found to develop high intra-trachea pressure because of large stone burden and prolonged operative time (130 min). This procedure was stopped and the patient received the second session of PCNL 1 week later.The mean total operative time was significantly shorter in the modified supine than in the prone position (67.7±24.5 min versus 91.5±29.8 min, P 0.05). Conclusion PCNL in modified supine Valdivia is as safe and effective as that of prone position for the treatment of renal stones, but the former is more time-saving than the latter. Key words: Nephrostomy, percutaneous; Supine position; Prone position; Retrospective studies