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

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 fo...

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Autores principales: Nour, Hani H., Kamal, Ahmed M., Ghobashi, Samir E., Zayed, Ahmed S., Rushdy, Mamdouh M., El-Baz, Ahmed G., Kamel, Ahmed I., El-Leithy, Tarek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442971/
https://www.ncbi.nlm.nih.gov/pubmed/26579247
http://dx.doi.org/10.1016/j.aju.2012.12.007
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author Nour, Hani H.
Kamal, Ahmed M.
Ghobashi, Samir E.
Zayed, Ahmed S.
Rushdy, Mamdouh M.
El-Baz, Ahmed G.
Kamel, Ahmed I.
El-Leithy, Tarek
author_facet Nour, Hani H.
Kamal, Ahmed M.
Ghobashi, Samir E.
Zayed, Ahmed S.
Rushdy, Mamdouh M.
El-Baz, Ahmed G.
Kamel, Ahmed I.
El-Leithy, Tarek
author_sort Nour, Hani H.
collection PubMed
description 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.
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spelling pubmed-44429712015-11-17 Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience Nour, Hani H. Kamal, Ahmed M. Ghobashi, Samir E. Zayed, Ahmed S. Rushdy, Mamdouh M. El-Baz, Ahmed G. Kamel, Ahmed I. El-Leithy, Tarek Arab J Urol Stones / Endourology Original article 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. Elsevier 2013-03 2013-02-04 /pmc/articles/PMC4442971/ /pubmed/26579247 http://dx.doi.org/10.1016/j.aju.2012.12.007 Text en © 2013 Arab Association of Urology. Production and hosting by Elsevier B.V. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Stones / Endourology Original article
Nour, Hani H.
Kamal, Ahmed M.
Ghobashi, Samir E.
Zayed, Ahmed S.
Rushdy, Mamdouh M.
El-Baz, Ahmed G.
Kamel, Ahmed I.
El-Leithy, Tarek
Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience
title Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience
title_full Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience
title_fullStr Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience
title_full_unstemmed Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience
title_short Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience
title_sort percutaneous nephrolithotomy in the supine position: safety and outcomes in a single-centre experience
topic Stones / Endourology Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442971/
https://www.ncbi.nlm.nih.gov/pubmed/26579247
http://dx.doi.org/10.1016/j.aju.2012.12.007
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