Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trial
Background: The aim of this study intends to assess prone and flexed prone positions for percutaneous nephrolithotomy (PNL) for safety and efficacy. Methods: From May 2017 to August 2022, a stratified randomized approach was carried out to randomly assign 346 PNL candidates into prone or flexed pron...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Urology Annals |
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| Online Access: | https://journals.lww.com/10.4103/ua.ua_36_24 |
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| author | Diaa-Eldin Taha Ali Ibrahim Ahmed Zeid Eslam Shokry Tarek Abdelbaky Hossam Nabeeh |
| author_facet | Diaa-Eldin Taha Ali Ibrahim Ahmed Zeid Eslam Shokry Tarek Abdelbaky Hossam Nabeeh |
| author_sort | Diaa-Eldin Taha |
| collection | DOAJ |
| description | Background:
The aim of this study intends to assess prone and flexed prone positions for percutaneous nephrolithotomy (PNL) for safety and efficacy.
Methods:
From May 2017 to August 2022, a stratified randomized approach was carried out to randomly assign 346 PNL candidates into prone or flexed prone groups. Perioperative data, such as stone-free rate, stay length, operative time, and complication rates, were studied.
Results:
In the prone and flexed prone groups, the mean ages of 51.7 ± 12.2 and 49.4 ± 11.9 min, respectively (P = 0.1). The mean body mass indexes of 24.2 ± 13.4 and 29.9 ± 11.9, respectively (P = 0.03). The pyelocaliceal perforation occurred in 15 (8%) and 11 (6.4%) participants, respectively. In the prone and flexed prone postures, postoperative bleeding occurred in 15 (7.9%) and 9 (5.4%) patients, respectively (P = 1.0). The average percentage decrease in hemoglobin concentration was 1.29 ± 0.42 and 1.21 ± 0.32, respectively (P < 0.000). The success rates were 92 and 93.6%, respectively (P = 0.6). The average access length was 3.9 ± 1.2 and 4.8 ± 1.8 min (P = 0.08), whereas the average operation duration was 68.7 ± 37.4 and 50.4 ± 21.9 min (P = 0.04).
Conclusion:
Both the prone and prone-flexed positions are equally safe for PNL. The flexed prone position is more likely to be beneficial for obese patients. The prone-flexed position enabled a somewhat shorter average operation time. The pelvicalyceal system could be more readily reached when the prone position was flexed. |
| format | Article |
| id | doaj-art-bd716f0d052a41fa96347865beb7c8c8 |
| institution | Kabale University |
| issn | 0974-7796 0974-7834 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Urology Annals |
| spelling | doaj-art-bd716f0d052a41fa96347865beb7c8c82025-02-06T07:30:03ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342025-01-01171323710.4103/ua.ua_36_24Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trialDiaa-Eldin TahaAli IbrahimAhmed ZeidEslam ShokryTarek AbdelbakyHossam NabeehBackground: The aim of this study intends to assess prone and flexed prone positions for percutaneous nephrolithotomy (PNL) for safety and efficacy. Methods: From May 2017 to August 2022, a stratified randomized approach was carried out to randomly assign 346 PNL candidates into prone or flexed prone groups. Perioperative data, such as stone-free rate, stay length, operative time, and complication rates, were studied. Results: In the prone and flexed prone groups, the mean ages of 51.7 ± 12.2 and 49.4 ± 11.9 min, respectively (P = 0.1). The mean body mass indexes of 24.2 ± 13.4 and 29.9 ± 11.9, respectively (P = 0.03). The pyelocaliceal perforation occurred in 15 (8%) and 11 (6.4%) participants, respectively. In the prone and flexed prone postures, postoperative bleeding occurred in 15 (7.9%) and 9 (5.4%) patients, respectively (P = 1.0). The average percentage decrease in hemoglobin concentration was 1.29 ± 0.42 and 1.21 ± 0.32, respectively (P < 0.000). The success rates were 92 and 93.6%, respectively (P = 0.6). The average access length was 3.9 ± 1.2 and 4.8 ± 1.8 min (P = 0.08), whereas the average operation duration was 68.7 ± 37.4 and 50.4 ± 21.9 min (P = 0.04). Conclusion: Both the prone and prone-flexed positions are equally safe for PNL. The flexed prone position is more likely to be beneficial for obese patients. The prone-flexed position enabled a somewhat shorter average operation time. The pelvicalyceal system could be more readily reached when the prone position was flexed.https://journals.lww.com/10.4103/ua.ua_36_24percutaneous nephrolithotomyprone-flexed positionprone position |
| spellingShingle | Diaa-Eldin Taha Ali Ibrahim Ahmed Zeid Eslam Shokry Tarek Abdelbaky Hossam Nabeeh Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trial Urology Annals percutaneous nephrolithotomy prone-flexed position prone position |
| title | Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trial |
| title_full | Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trial |
| title_fullStr | Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trial |
| title_full_unstemmed | Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trial |
| title_short | Prone versus prone-flexed position in percutaneous nephrolithotomy: A randomized controlled trial |
| title_sort | prone versus prone flexed position in percutaneous nephrolithotomy a randomized controlled trial |
| topic | percutaneous nephrolithotomy prone-flexed position prone position |
| url | https://journals.lww.com/10.4103/ua.ua_36_24 |
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