Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience.

Autor:	Nour HH; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt., Kamal AM; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt., Ghobashi SE; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt., Zayed AS; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt., Rushdy MM; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt., El-Baz AG; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt., Kamel AI; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt., El-Leithy T; Urology Department, Theodor Bilharz Research Institute, Giza, Egypt.
Jazyk:	angličtina
Zdroj:	Arab journal of urology [Arab J Urol] 2013 Mar; Vol. 11 (1), pp. 62-7. Date of Electronic Publication: 2013 Feb 04.
DOI:	10.1016/j.aju.2012.12.007
Abstrakt:	Objectives: To assess the feasibility of performing percutaneous nephrolithotomy (PCNL) with the patient supine. Although PCNL with the patient prone is the standard technique for treating large (>2 cm) renal stones including staghorn stones, we evaluated the safety and efficacy of supine PCNL for managing large renal stones, with special attention to evaluating the complications. Patients and Method: In a prospective study between January 2010 and December 2011, 54 patients with large and staghorn renal stones underwent cystoscopy with a ureteric catheter inserted, followed by puncture of the collecting system while they were supine. Tract dilatation to 30 F was followed by nephroscopy, stone disintegration using pneumatic lithotripsy, and retrieval using a stone forceps. All patients had a nephrostomy tube placed at the end of the procedure. The results were compared with those from recent large series of supine PCNL. Results: The median (range) operative duration was 130 (90-210) min, and the mean (SD) volume of irrigant was 22.2 (3.7) L. One puncture was used to enter the collecting system in 51 renal units (94%), while three units (6%) with a staghorn stone needed two punctures. The stone clearance rate was 91%, and five patients had an auxiliary procedure. There were complications in 15 patients (28%). All patients were stone-free at a 3-month follow-up. Conclusion: Supine PCNL is technically feasible; it has several advantages to patients, urologists and anaesthesiologists. It gives stone-free rates and a low incidence of organ injury comparable to those in standard prone PCNL.
Databáze:	MEDLINE
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