فهرست نشریات علمی دسترسی آزاد ایران

Introduction: Nephrolithiasis is a condition that is very common around the world. The gold standard for treating big renal calculi is Percutaneous nephrolithotomy (PCNL), which is often carried out in the prone position. Recently, there has been an increase in interest in supine PCNL in the global endourology arena.Method: This is a prospective comparative study. 53 patients with renal stones underwent PCNL, done by a single expert surgeon, the patients were divided randomly into 2 groups, 26 of them operated with supine percutaneous nephrolithotomy and 27 with prone percutaneous nephrolithotomy. Patient’s demographics, access time, operative duration, stone-free rate, post-operative hemoglobin drop and complications were compared.Results: The demographics and characteristics of the stones were similar in both groups. The supine position for PCNL demonstrated a notably shorter operative time compared to the prone position for PCNL., 60.3±3.7 min vs 79.7±2.5min (P-value<0.001).  The stone-free rate at 1-month duration was slightly better for prone, 24 patients (88.9%) for prone and 22 patients (84.6%) for supine, but statistically not significant (P-value 0.645). Hospital stays were 50.3±6.7 hr for supine and 52.65±6.4 hr for prone respectively (P-value 0.198). Hb drops were comparable, 1.22±0.09 in supine and 1.26±0.096 in prone (P-value 0.124). Post-operative Complications were found to be 4 patients (15.4%) of which (2 with fever and hematuria, and 2 with hematuria only) occurred in supine while 5 patients (18.5%) had occurred in prone group (1 with fever only, 2 with fever and hematuria, and 2 with hematuria only) (P-value 0.761). Patients had no complications Clavien grade III or higher in both groups.Conclusion: Supine PCNL is as safe and effective procedure as prone, with comparable stone-free rate and complications, with added advantage of a significantly lower operative time.