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Supine PCNL

Ahmed Sakr, Emad Salem, Mostafa Kamel, Esam Desoky, Ahmed Ragab, Mohamed Omran, Amr Fawzi, Ashraf Shahin
To assess the safety and efficacy of minimally invasive percutaneous nephrolithotomy (mPCNL) as compared to standard PCNL (sPCNL) for management of 2-3-cm renal stones in the flank-free modified supine position. Between September 2010 and December 2013, 150 patients (168 renal units) with 2-3-cm renal stones were prospectively randomized into two treatment groups; Group A (75 patients/87 renal units) treated by mPCNL and Group B (75 patients/81 renal units) treated by sPCNL. In both groups, the patients were placed in the flank-free modified supine position...
February 22, 2017: Urolithiasis
Arvind P Ganpule, Mohankumar Vijayakumar, Ankur Malpani, Mahesh R Desai
INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is the preferred treatment of choice for renal calculi. PCNL has evolved remarkably since the eighties when it was first described. APPROACH: Approach might be by either supine or prone and the access is made with the help of either fluoroscopy or ultrasound. Recently endoscopy guided puncture has also been described. MINIATURIZATION: Traditionally the tract size for PCNL used to be 30Fr. Even though the stone clearance rate was good there were complications such as bleeding With the advent of excellent optics and advances in stone fragmentation the tract size has reduced to a great extent which has reduced the complications without compromising the stone clearance...
December 2016: International Journal of Surgery
Siavash Falahatkar, Gholamreza Mokhtari, Mojtaba Teimoori
PURPOSE: To compare results of studies on supine and prone percutaneous nephrolithotomy (PCNL) techniques to find the best position for treating kidney stones. MATERIALS AND METHODS: A systematic literature review was done in April 2016 using PubMed, Scopus, and Web of Science databases to identify the relevant studies. Article selection was based on the preferred reporting elements of systematic reviews and meta-analysis criteria. A subgroup analysis was done comparing standard prone and supine PCNLs separately...
October 10, 2016: Urology Journal
Stefano Paolo Zanetti, Luca Boeri, Michele Catellani, Andrea Gallioli, Alberto Trinchieri, Kemal Sarica, Emanuele Montanari
OBJECTIVE: A wide selection of both anterograde and retrograde mini-invasive procedures exist for stones' treatment. The 2016 European Association of Urology (EAU) guidelines still don't univocally define a best option. Our purpose is to give an overview on some European Stone Centers' customs and to compare real life clinical practice with statements of opinion leaders and Guidelines. MATERIALS AND METHODS: In 2015 we performed a survey in 3 step about the spread of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) techniques among EAU Section of Urolithiasis (EULIS) members...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Siavash Falahatkar, Aliakbar Allahkhah, Majid Kazemzadeh, Ahmad Enshaei, Maryam Shakiba, Fahimeh Moghaddas
INTRODUCTION AND HYPOTHESIS: To compare complications and outcomes of complete supine percutaneous nephrolithotomy (csPCNL) with ultrasound guided and fluoroscopically guided procedure. MATERIALS AND METHODS: In this randomized clinical trial study from January 2009 to September 2010, 26 of 51 patients with renal stones underwent csPCNL with ultrasonographic guidance in all steps of the procedure (group A), and the other 25 patients underwent standard fluoroscopically guided csPCNL (group B)...
July 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
David K-C Mak, Yuko Smith, Noor Buchholz, Tamer El-Husseiny
OBJECTIVE: To review the literature reporting the technique of percutaneous nephrolithotomy (PCNL) and outcomes for prone and supine PCNL, as PCNL is an established treatment for renal calculi and both prone and supine PCNL have been described, but there has been much debate as to the optimal position for renal access in PCNL. METHODS: A review of the medical literature was conducted using the PubMed database to identify relevant studies reporting on prone and supine PCNL published up until July 2015...
June 2016: Arab Journal of Urology
Ramanitharan Manikandan, Jayesh Kumar Mittal, Lalgudi Narayanan Dorairajan, Amit Kumar Mishra, Kodakkatil Sreenivasan Sreerag, Anil Verma
PURPOSE: The management of simultaneous renal and ureteral calculi usually require staged procedure or change of position from supine lithotomy for ureterorenoscopic lithotripsy to prone for conventional percutaneous nephrolithotomy (PCNL). We review our experience with endoscopic combined intrarenal surgery (ECIRS) in the management of this condition. MATERIALS AND METHODS: A total of 43 patients with simultaneous renal and ureteral calculi underwent ECIRS in Galdakao-modified supine Valdivia (GMSV) position from June 2012 to March 2016...
October 2016: Journal of Endourology
Madeleine Nina Jones, Weranja Ranasinghe, Richard Cetti, Bradley Newell, Kevin Chu, Matthew Harper, John Kourambas, Philip McCahy
PURPOSE: The traditional prone positioning of percutaneous nephrolithotomy (PCNL) is associated with various anesthetic and logistic difficulties. We aimed to compare the surgical outcomes of PCNLs performed using our modified supine position with those performed in the standard prone position. MATERIALS AND METHODS: A prospective group of 236 renal units (224 patients) undergoing PCNL were included in this 2 site study: 160 were performed in the modified supine position were compared with 76 undergoing PCNL in the prone position...
July 2016: Investigative and Clinical Urology
Luigi Quaresima, Alessandro Conti, Alexia Vici, Marco Tiroli, Daniele Cantoro, Admena Rreshketa, Emanuele Principi, Matteo Tallè, Luca Moroni, Mahmoud Yehia, Giovanni Muzzonigro
OBJECTIVE: Aim of the present study was to evaluate the safety and efficacy of Percutaneous Nephrolithotomy (PCNL) in the Galdakao- Modified Supine Valdivia (GMSV) position in order to predict operative time, stone-free rate and onset of complications taking into account comorbidity, stone-related parameters and anatomic upper urinary tract abnormalities. MATERIAL AND METHODS: A prospective evaluation of patients who underwent to PCNL in GMSV position for renal stones > 2 cm, from January 2009 to February 2015 was performed...
July 4, 2016: Archivio Italiano di Urologia, Andrologia
Anna Bujons, Félix Millán, Clara Centeno, Esteban Emiliani, Francisco Sánchez Martín, Oriol Angerri, Jorge Caffaratti, Humberto Villavicencio
INTRODUCTION: Shock wave lithotripsy (SWL) is the treatment of choice for most cases of renal lithiasis in children. Some cases, however, are refractory to SWL and may be associated with anatomic and metabolic changes or a large stone burden. In these circumstances, mini-percutaneous nephrolithotomy (mini-PCNL) is an option. OBJECTIVE: The aim was to assess the safety and efficacy of high-power holmium YAG (Ho:YAG) laser in mini-PCNL for staghorn calculi. PATIENTS AND METHODS: The clinical records relating to 35 mini-PCNLs (Table) performed between January 2008 and December 2012 in 33 patients (27 boys and 6 girls; mean age 7 years, range 2-18 years) were retrospectively reviewed...
August 2016: Journal of Pediatric Urology
DongBo Yuan, YongDa Liu, HaoFu Rao, TianFei Cheng, ZhaoLin Sun, YuanLin Wang, Jun Liu, WeiHong Chen, WeiDe Zhong, JianGuo Zhu
BACKGROUND: There are several positions in the operation of percutaneous nephrolithotomy (PCNL), such as prone position, supine position, flank position, and modified supine position for PCNL, but the supine and prone positions are the main two choices for several years. However, there is still discrepancy on the optimal position for PCNL. Therefore, we performed this meta-analysis to evaluate safety and efficacy of the supine versus the prone position in PCNL for renal calculi. METHODS: We searched MEDLINE, SCOPUS, and the Cochrane database libraries to look for relevant studies...
July 2016: Journal of Endourology
Khurshid R Ghani, Sero Andonian, Matthew Bultitude, Mihir Desai, Guido Giusti, Zhamshid Okhunov, Glenn M Preminger, Jean de la Rosette
CONTEXT: Percutaneous nephrolithotomy (PCNL) is the surgical standard for treating large or complex renal stones. Since its inception, the technique of PCNL has undergone many modifications. OBJECTIVE: To perform a collaborative review on the latest evidence related to outcomes and innovations in the practice of PCNL since 2000. EVIDENCE ACQUISITION: A literature review was performed using the PubMed database between 2000 and July 2015, restricted to human species, adults, and the English language...
August 2016: European Urology
Mordechai Duvdevani
No abstract text is available yet for this article.
July 2016: Journal of Endourology
Hakan Öztürk
Colonic injury during percutaneous nephrolithotomy (PCNL) persists despite the advances in technical equipment and interventional radiology techniques. According to the Clavien-Dindo classification of surgical complications, colonic injury is regarded as a stage IVa complication. Currently, the rate of colonic injury ranges between 0.3% and 0.5%, with an unremarkable difference in incidence between supine and prone PCNL procedures. Colon injury is the most significant complication of PCNL. Colonic injury can result in more complicated open exploration of the abdomen, involving colostomy construction...
2015: Reviews in Urology
J A Salvadó, C E Mendez
Percutaneous nephrolithotripsy (PCNL) is today gold standard for the management of complex urinary calculi. Over its lifespan this surgery has been subjected to multiple modifications and variants: for example, the anatomical positioning of the patient is still under controversy, especially the opposition amongst the prone and supine approaches, the two most common patient positions currently used for PCNL. Our objective was to review the literature and to discuss advantages and drawbacks from either technique...
December 2015: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Mario Sofer, Guido Giusti, Silvia Proietti, Ishai Mintz, Maharan Kabha, Haim Matzkin, Galit Aviram
PURPOSE: We assessed the approachability of the upper calyx through lower calyx access for prone and supine percutaneous nephrolithotomy and used computerized tomography to analyze anatomical factors that may influence it. MATERIALS AND METHODS: A prospective series of 45 patients treated with percutaneous nephrolithotomy were operated on in the prone (20) and supine (25) positions. Computerized tomography simulated access to the lower and upper calyx longitudinal axes were used to measure skin-to-lower calyx distance, thickness of the body wall, muscle and fat, the muscle-to-fat thickness ratio and the angle between the lower calyx tract and the upper calyx axis...
February 2016: Journal of Urology
Arvind K Shah, Kewei Xu, Hao Liu, Hai Huang, Tianxin Lin, Liangkuan Bi, Han Jinli, Xinxiang Fan, Rujan Shrestha, Jian Huang
BACKGROUND AND PURPOSE: Miniatured percutaneous nephrolithotomy (PCNL) techniques such as micro-PCNL (microperc) and ultramini-PCNL (UMP) are usually indicated for renal stones <2 cm. We present our preliminary report of treating patients with 2 to 3 cm renal stones using UMP in a semisupine combined lithotomy position associated with a retrograde ureteral access sheath (UAS). METHODS: From April 2013 to January 2014, we implemented 13F UMP for 22 patients with renal stones that were 2 to 3 cm with the patient positioned in a 45-degree semisupine combined lithotomy position...
November 2015: Journal of Endourology
Osama A El-Wahab, Magdy A El-Tabey, Ehab El-Barky, Shabieb A El-Baky, Adel El-Falah, Medhat Refaat
OBJECTIVE: To compare the outcome of treatment planning using multislice computed tomography (CT) or intravenous urography (IVU) for supine percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: The study included 60 patients with renal stones, all treated by supine PCNL, between March 2011 and October 2012. The patients were divided randomly into two equal groups; in group 1 30 patients had the PCNL access planned based on IVU findings, and in group 2 the PCNL access was planned based on multislice CT images...
June 2014: Arab Journal of Urology
Michael Siev, Piruz Motamedinia, David Leavitt, Mathew Fakhoury, Kevin Barcohana, David Hoenig, Arthur D Smith, Zeph Okeke
PURPOSE: Percutaneous nephrolithotomy is commonly performed with the patient prone. There is concern that the prone position, especially in obese patients, negatively affects ventilation due to the restriction of chest compliance and respiratory mechanics. We analyzed the change in airway resistance between supine and prone positioning of patients undergoing percutaneous nephrolithotomy. MATERIALS AND METHODS: We retrospectively reviewed the intraoperative respiratory parameters of 101 patients who underwent prone percutaneous nephrolithotomy...
November 2015: Journal of Urology
W Gamal, E Moursy, M Hussein, A Mmdouh, A Hammady, M Aldahshoury
INTRODUCTION/BACKGROUND: Many authors reported their experience with supine PCNL in adult population comparing the outcome with prone PCNL and they found that the stone free rate and the operative time were in favor of prone PCNL with a lower patient morbidity among patients with supine PCNL. This encouraged us to perform supine PCNL in pediatric population. AN OBJECTIVE: In this study we evaluated the safety and efficacy of supine PCNL in pediatric population. STUDY DESIGN (SUBJECTS/PATIENTS/MATERIALS/METHODS): Between April 2011 and February 2014 a total of 27 children (6 girls and 21 boys) presented with renal calculi...
April 2015: Journal of Pediatric Urology
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