Percutaneous Nephrolithotomy in Supine Position in our Experience

Abstract

Background: Percutaneous access to the kidney with the patient in supine position was described in 1998. Although not frequently used in Pakistan there is a constant effort to adopt the supine position, primarily because it offers certain advantages over prone position. Objective: To present our experience in performing supine percutaneous nephrolithotomy and to compare our results with those reported in the international literature. Study type, settings & duration: A retrospective study was conducted at Federal Government Polyclinic hospital Islamabad from January 2015 to January 2020. Methodology: The medical records of 63 patients that underwent supine percutaneous nephrolithotomy were reviewed. The evaluated variables were: age, gender, body mass index, stone location and size, surgery duration, success rate, and complications. Results: A total of 63 patients and 70 kidneys were treated. The mean age of the patients was 41.7 years (16-76) with predominance of males 37 (58%) while there were 26 (42%) females. Mean body mass index was 25 m2 (18-34), mean stone size was 31 mm (12-80).Topography of the calculi was pelvic, 17 (24.2%); caliceal system; inferior 16 (22.8%), middle 3 (4.2%), superior 5 (7.14%). and mean duration of surgery was 80 min (30-160). The first intervention success rate was 90%, the second intervention success rate was 95%, and the complication rate was 11% (Clavien: I and II). Conclusion: Supine percutaneous nephrolithotomy is safe and efficacious, with a high success rate, low complication rate, and undisputable advantages of anesthesia management.

Keywords

• percutaneous nephrolithotomy
• supine position
• kidney stones
• staghorn calculi