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Type: Journal article
Title: Percutaneous nephrolithotomy in the supine position: A neglected approach?
Author: Steele, D.
Marshall, V.
Citation: Journal of Endourology, 2007; 21(12):1433-1437
Publisher: Mary Ann Liebert Inc Publ
Issue Date: 2007
ISSN: 0892-7790
Statement of
Denby Steele and Villis Marshall
Abstract: Purpose: The aim of the study was to demonstrate the safety and effectiveness of single-stage percutaneous nephrolithotomy performed in the supine position. Patients and Methods: A single surgeon performed 322 consecutive percutaneous nephrolithotomies in patients in the supine position between 1999 and 2006, which were studied prospectively. Results: There were no complications related to the supine position, and in only one patient was there failed access. This patient's kidney was subsequently punctured with the patient in the supine position. There were no colonic injuries, no pneumothoraces, and a transfusion rate of 3.7%. Surgery on all patients with stones, including staghorn calculi and bilateral stones managed synchronously, was in the supine position. The median time to percutaneous access in a timed cohort of 27 patients was 5 minutes. The stone clearance rate was 91%. The median length of hospital stay was reduced from 6 days in the initial unstented patients to 3 days in the study overall when most patients received stents. Conclusions: Percutaneous nephrolithotomy in the supine position is safe, effective, and suitable for the majority of patients. It offers the potential advantages of better urethral access, less patient handling, and the need to only drape once, thus reducing the overall operative time compared to the traditional prone position.
Keywords: Humans; Kidney Calculi; Tomography, X-Ray Computed; Cystoscopy; Nephrostomy, Percutaneous; Treatment Outcome; Follow-Up Studies; Prospective Studies; Supine Position; Adult; Aged; Aged, 80 and over; Middle Aged; Female; Male
Description: copyright 2007 Mary Ann Liebert
RMID: 0020074537
DOI: 10.1089/end.2006.0375
Appears in Collections:Surgery publications

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