Evaluation of the Effectiveness of Percutaneous Nephrolithotomy in Supine and Prone Positions: A Prospective Interventional Study from Telangana, India

Abstract

Introduction: Percutaneous Nephrolithotomy (PCNL) is the preferred method for treating large or complex renal calculi. Despite positive results and apparent benefits over the prone position, there are few randomised trials comparing the supine and prone positions. Aim: To evaluate the effectiveness of PCNL in prone and supine positions in terms of operative time, stone-free rate, hospital stay, postoperative complications, and the level of haemoglobin drop. Materials and Methods: The study was conducted from December 2020 to December 2022, at the Department of Urology, Mamata Medical College in Khammam, Telangana, India. Patients with renal stones diagnosed by Non-Contrast Computed Tomography (NCCT) Kidney Ureter Bladder (KUB) and meeting the inclusion criteria were enrolled. Patient demographic data, operative time, stone-free rate, haemoglobin level drop, postoperative fever, and hospital stay in prone and supine positions were recorded. Statistical tests like chi-square or Fisher-exact test were used to compare proportions, and the student t-test was used to compare means. Results: The overall operative time was 79.50 minutes in the prone group and 66.78 minutes in the supine group (p=0.0213). The average hospital stay was 2.68 days in the prone group and 2.72 days in the supine group (p=0.2432). Fall in haemoglobin levels, size of stones extracted, and stone-free rate at three months between the two groups (p>0.05) showed insignificant relation. Furthermore, there was no significant difference in complications between the two groups (p>0.05). Conclusion: PCNL performed with the patient in the supine position requires significantly less time during surgery. There was no significant difference in terms of stone-free rate, hospital stay, fall in haemoglobin levels, and complications between the supine and prone groups.