MP75-04 THE EFFECT OF STONE PREVENTION COUNSELING AT THE INITIAL CONSULTAION ON 24-HOUR URINE COLLECTION RESULTS (“CLINIC EFFECT”)

Abstract

METHODS: We performed a retrospective analysis of our prospective database of consecutive patients that underwent to PCNL between July 2011 and July 2014. The variables analyzed were gender, age, body mass index (BMI), ASA score, stone diameter, Guy’s Stone Score (GSS), number of punctures, calyx puncture site, supracostal access and patient positioning. Complex cases were defined as GSS 3 or 4 based on the preoperative CT scan analysis. Complications were graded according to the modified Clavien Classification and Clavien >1⁄43 were considered as major complications. Success was considered as fragments <1⁄44 mm on the first post-operative day (POD1) on CT scan. The tests used in the univariate analyzes were chi-square and Fisher Exact test for categorical measures and Student’s t-test for independent samples continuous parameters. We used a 0.05 significance level. RESULTS: Of the 517 PCNL performed, 240 (46.4%) with GGS 3 or 4 were included in the study. Regarding patient position, 21.2% were in prone position and 79.8% were in supine position (80% in complete supine position, 6.8% in classic Valdivia and 13.1% in Galdakao position). Both groups were similar according mean age, BMI, gender, ASA Score, stone diameter, number of punctures. Supracostal access was necessary in 25.5% of the cases in ventral position against 10.5% in supine position (p1⁄40.01) (Table 1). The success rates, major Clavien complications, blood transfusions and surgical time were not different between the groups (Table 2). CONCLUSIONS: Supine or prone positions were equally suitable for PCNL of complex stones and did not impact the outcomes. The choice of the patient position should be driven by the surgeon’s preference.