Comparative Study of Prone Position Variations for Percutaneous Nephrolithotomy

Abstract

Objective

In this comparative study, we evaluated the results of flat prone and prone hip flexed percutaneous nephrolithotomy in terms of efficacy and safety to contribute to the optimal prone percutaneous nephrolithotomy position.

Materials and Methods

Data of the patients who underwent percutaneous nephrolithotomy operations in a flat-prone or prone hip flexed positions due to renal pelvis and/or ≥2 Calix filling stones between January 2016 and January 2022 were collected retrospectively. Demographic data of the patient groups in different prone positions as well as clinical findings, stone characteristics and operative data were analyzed. The groups were also compared in terms of post-operative findings and complications.

Results

The average age and CROES scores of patients included in the study were 47.15±15.6 years and 221.76±62.49, respectively. There was no statistically significant difference between the two groups in terms of patient demographic data, stone-free status and complication rates. Operation Room Time (ORT) (min) in flat prone PCNL group was shorter in average (100.57±32.74 min vs 92.32±28.75 min, p = 0.041) and duration with nephrostomy (days) and hospitalization (days) parameters were statistically significantly shorter in prone hip flexed PCNL (respectively, p < 0.001; p = 0.005).

Conclusion

Flat-prone PCNL provides significantly shorter ORT. However, the time with nephrostomy and hospitalization with the prone hip flexed PCNL were shorter than flat-prone position. The findings will guide the optimal prone PCNL position.

Keywords:

• flat prone position
• hip flexed prone position
• kidney stone
• percutaneous nephrolithotomy

Data Sharing Statement

Although the data of the study are not available to the public due to privacy or ethical restrictions, it can be obtained from the corresponding author if requested.

Statement of Ethics

In our study with human participants, ethical standards of the 1964 Helsinki Declaration were complied with, as well as the ethical standards of the national research association at the procedural stages. We obtained informed consent from patients included in the study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.