Percutaneous nephrolithotomy in the oblique supine lithotomy position and prone position: A comparative study

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Al-Dessoukey A.A.; Moussa A.S.; Abdelbary A.M.; Zayed A.; Abdallah R.; Elderwy A.A.; Massoud A.M.; Aly A.H.

Journal: Journal of Endourology

Publisher: Mary Ann Liebert Inc.

Publication Date: 1 September 2014

Volume / Issue: Volume 28 / Issue 9

Pages: 1058–1063

ISSN: 8927790

DOI: 10.1089/end.2014.0078

Scopus: View on Scopus

PubMed: 24856575

Document Type: Article

Authors and Affiliations

Al-Dessoukey A.A., Department of Urology, Faculty of Medicine, Beni Suef University, Beni Suef 62511, Egypt; Moussa A.S., Department of Urology, Faculty of Medicine, Beni Suef University, Beni Suef 62511, Egypt; Abdelbary A.M., Department of Urology, Faculty of Medicine, Beni Suef University, Beni Suef 62511, Egypt; Zayed A., Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt; Abdallah R., Department of Urology, Faculty of Medicine, Beni Suef University, Beni Suef 62511, Egypt; Elderwy A.A., Department of Urology, Assuit University Hospital, Assuit, Egypt; Massoud A.M., Department of Urology, Faculty of Medicine, Beni Suef University, Beni Suef 62511, Egypt; Aly A.H., Department of Urology, Cairo University, Cairo, Egypt

Abstract

Objectives: To compare the safety, efficacy, and complications of percutaneous nephrolithotomy (PCNL) in the oblique supine lithotomy position vs the prone position in a randomized comparative study. Patients and Methods: The study included 101 and 102 patients in the oblique supine lithotomy position and prone position, respectively. Inclusion criteria were renal and upper ureteral stones. Exclusion criteria were uncorrectable bleeding disorders, active urinary tract infection, and pregnancy. Results: Both the groups were comparable regarding the male/female ratio, stone size, and site. No significant differences were found in terms of the stone-free rate, blood transfusion rate, and complication rates. Significant differences were reported in mean hemoglobin loss (-1.03 and-2.18 g/dL), mean operative time (86.16 and 111.7 minutes), and mean hospital stay (49.88 and 81.2 hours) in the supine and prone positions, respectively, and anesthesiological parameters (the mean blood pressure decreased by 2 and 14.06 mm Hg, the mean heart rate changed by-0.82 and +13.28 beat/minute, and the peak air way pressure changed by +1.08 cm H2O and +7.56 cm H2O in the supine and prone positions, respectively). Conclusions: PCNL in both positions was equally successful with no significant differences in complications. PCNL in the oblique supine lithotomy position was superior to PCNL in the prone position regarding operative time, hospital stay, and effects on respiratory and cardiovascular status, making it more comfortable for patients and anesthesiologists. Morbidly obese patients, patients with cardiologic disorders, and patients with pulmonary obstructive airway disease need further studies to show if they would benefit from these differences. Additionally, it is more comfortable for the surgeon with little challenges added in the initial puncture. © 2014 Mary Ann Liebert, Inc.

Keywords

Adult; Anesthesia, General; Blood Pressure; Blood Transfusion; Female; Heart Rate; Humans; Kidney; Kidney Calculi; Length of Stay; Male; Middle Aged; Nephrostomy, Percutaneous; Obesity, Morbid; Operative Time; Patient Positioning; Prone Position; Prospective Studies; Supine Position; Treatment Outcome; Ureteral Calculi; blood; body posture; comparative study; controlled study; general anesthesia; human; operation duration; percutaneous nephrostomy; physiology; procedures; prospective study; randomized controlled trial; utilization

Citation Information

Scopus Citations: 54

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