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Split-leg Modified Lateral Versus Prone Position In Percutaneous Nephrolithotomy: A Prospective, Randomized Trial

Abul-fotouh Ahmed, Ahmed Gomaa, Abdullah Daoud, Ahmed A. A. Solyman, Hassan Abdelazim, Mohammed El-feky, Mohammed M. Agha, Ashraf H. Abdellatif, Ahmed A. Fahim
Published 2020 · Medicine
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Purpose Standard prone position (PP) during percutaneous nephrolithotomy (PNL) has multiple drawbacks. We aimed to compare PNLs performed in split-leg (SL) modified lateral position (MLP) and those performed in standard PP. Methods A prospective, randomized, unblind, double arm trial was conducted at a tertiary care academic medical center in Egypt, between November 2017 and October 2019. Adult patients with renal stones undergoing PNL were included. According to renal anatomy and stone complexity, stratified randomization was performed and study participants were allocated into either SL-MLP group or PP group. The stone free rate (SFR), total operative time, track formation time, fluoroscopy time, auxiliary procedures, and complications were compared. Results There were 61 patients in SL-MLP group and 63 patients in PP group. Both groups had similar baseline characteristics. The SFR was comparable between groups: 75.4% in SL-MLP group and 77.8% in PP group ( p  = 0.755). The mean total operative time was shorter and mean track formation time was longer in SL-MLP group (55.33 ± 20.73 vs. 98.49 ± 9.23, p  < 0.001 and 7.89 ± 3.68 vs. 6.52 ± 1.77, p  = 0.002). There was no significant difference in fluoroscopy time, total complication rates, hemoglobin reduction and need for blood transfusion between the groups. In SL-MLP group, all PNL procedures as well all the associated procedures were performed with the patients in the same position. Conclusion SL-MLP PNL has a short operative time and similar SFR and complication rate compared to PP PNL. SL-MLP allowed antegrade and retrograde access to the urinary tract without patient repositioning.
This paper references
10.1089/end.1993.7.307
Prone split leg and flank roll positioning: simultaneous antegrade and retrograde access to the upper urinary tract.
Michael A Grasso (1993)
10.1007/s00240-017-1015-9
Invited review: the tale of ECIRS (Endoscopic Combined IntraRenal Surgery) in the Galdakao-modified supine Valdivia position
Cesare Marco Scoffone (2017)
[Reoperative off-pump coronary artery bypass surgery for restenosis after percutaneous coronary intervention as a part of hybrid revascularization chronic renal failure on hemodialysis; report of a case].
Toshiya Kawashima (2002)
10.4111/icu.2016.57.4.268
Modified supine versus prone percutaneous nephrolithotomy: Surgical outcomes from a tertiary teaching hospital
Madeleine Nina Jones (2016)
10.1007/s00345-012-0889-y
A study on comparative outcomes of percutaneous nephrolithotomy in prone, supine, and flank positions
Hossein Karami (2012)
10.1016/j.urology.2010.12.026
The Guy's stone score--grading the complexity of percutaneous nephrolithotomy procedures.
Kay Thomas (2011)
10.1089/end.1990.4.269
Why is Percutaneous Nephroscopy Still Performed with the Patient Prone
J. Gabriel Valdivia (1990)
10.1016/S0090-4295(98)90035-8
Reverse lithotomy: modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women.
Travis Lehman (1988)
10.1093/bja/67.4.452
The prone position for the surgical patient: a historical review of the principles and hazards.
J. M. Anderton (1991)
10.1093/bja/aem380
Anaesthesia in the prone position.
Hilary Edgcombe (2008)
10.1159/000474462
Severe recurrent ureteral stricture: the combined use of an anterograde and retrograde approach in the prone split-leg position without X-rays.
Roberto Mario Scarpa (1997)
10.1016/j.urology.2011.03.012
The split-leg modified lateral position for percutaneous renal surgery and optimal retrograde access to the upper urinary tract.
Mohammed Lezrek (2011)
10.1089/end.2009.0099
Ultrasonography-guided percutaneous nephrolithotomy in the flank position versus fluoroscopy-guided percutaneous nephrolithotomy in the prone position: a comparative study.
Hossein Karami (2010)
10.1089/end.2010.0292
Systematic review and meta-analysis of percutaneous nephrolithotomy for patients in the supine versus prone position.
Liangren Liu (2010)
10.1007/s00345-011-0790-0
ECIRS (Endoscopic Combined IntraRenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery?
Cecilia Maria Cracco (2011)
10.1089/end.2007.0391
Totally ultrasonography-guided percutaneous nephrolithotomy in the flank position.
Abbas Basiri (2008)
Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position.
José Gabriel Valdivia Uría (1998)
10.1089/end.2011.0110
Supine versus prone position during percutaneous nephrolithotomy: a report from the clinical research office of the endourological society percutaneous nephrolithotomy global study.
José González Valdivia (2011)
10.1016/j.juro.2013.01.047
A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy.
Arthur D. Smith (2013)
10.1089/end.2009.0645
Heterogeneity in the reporting of disease characteristics and treatment outcomes in studies evaluating treatments for nephrolithiasis.
Elias S. Hyams (2010)
10.1089/089277902760261437
Lateral decubitus position for percutaneous nephrolithotripsy in the morbidly obese or kyphotic patient.
Ofer N Gofrit (2002)
10.1016/j.eururo.2008.01.067
Modified supine versus prone position in percutaneous nephrolithotomy for renal stones treatable with a single percutaneous access: a prospective randomized trial.
Marco de Sio (2008)
10.1089/end.2008.0283
Simultaneous anterograde and retrograde endourologic access: "the Barts technique".
Athanasios G. Papatsoris (2008)
10.1016/S0022-5347(17)35048-6
Percutaneous stone removal with the patient in a flank position.
Kurt Kerbl (1994)
10.5414/CN106787
Evaluating the definition of "stone free status" in contemporary urologic literature.
Levi A Deters (2011)
10.1007/978-2-8178-0459-0_22
Prone Versus Supine PNL: Results and Published Series
András Hoznek (2014)
10.1089/end.2008.0433
Percutaneous nephrolithotomy with ultrasonography-guided renal access in the lateral decubitus flank position.
Hossein Karami (2009)
10.1097/01.sla.0000133083.54934.ae
Classification of Surgical Complications: A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey
Daniel Dindo (2004)
10.1089/0892779041271670
Supine position is safe and effective for percutaneous nephrolithotomy.
Man-Tat Ng (2004)
10.1016/j.eururo.2008.08.069
Prone or supine: is this the question?
Riccardo Autorino (2008)
10.1089/end.2008.9726
Concomitant percutaneous nephrolithotomy and transperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction complicated by stones.
Anshuman Agarwal (2008)



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