Is Supine Mini Percutaneous Nephrolithotomy better than Prone Mini Percutaneous Nephrolithotomy: A Single-Center Experience

*Corresponding author: Mohsin Quadri*, Arun Kumar B, Nitesh Jain, Murali Venkatraman and Priyank Shah

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observational study

Abstract

Objective

Miniaturized percutaneous nephrolithotomy (mini-PCNL) is the primary treatment modality in stone management. However, prone and supine positioning remains a matter of concern because of associated complications and morbidity. The present study aimed to compare success and complication rates of supine and prone position in patients undergoing mini-PCNL.

Material and Methods

A prospective observational study was conducted in patients (age >18-years) with renal calculi 1-3 cm in size who performed mini-PCNL between September 2017 and February 2019. The stone size was determined by computed tomography (CT) scan and kidney, ureter, and bladder X-ray. Post-operative parameters and complications were compared in both the groups. Statistical significance was defined as p<0.05.

Results

A total of 116 patients were enrolled (52 in the supine mini-PCNL group and 64 patients in the prone mini PCNL groups). The mean operative time was significantly lower (44.80 mins) in supine mini-PCNL compared to the prone mini-PCNL (53.93 mins) (p<0.0074). The mean hospital stays in supine and prone mini-PCNL group was 2.06 and 2.51-days, respectively (p=0.01). A complete stone clearance was observed in supine mini-PCNL group. The incidence of tubeless and totally tubeless procedure was significantly higher in supine mini-PCNL group (90% and 61%, respectively) (p<0.0001). No difference in terms of complications is reported between the supine and prone mini-PCNL group.

Conclusion

Supine mini-PCNL and prone mini-PCNL found to be comparable in terms of success rate and complications. However, supine mini-PCNL can be preferred due to its shorter operative time in the patients with renal stones.

Keywords

Percutaneous nephrolithotomy; Prone position; Supine position; Stone free rate.