Urology and Nephrology Research Center (UNRC), Shohada Medical Center, Shahid Beheshti University, M.C. (SBMU), No. 103, Boostan 9th St., Pasdaran Ave., P.O.Box: 1666677951, Tehran, I.R. Iran,
World J Urol. 2013 Oct;31(5):1225-30. doi: 10.1007/s00345-012-0889-y. Epub 2012 Jun 13.
To compare percutaneous nephrolithotomy (PCNL) safety and efficacy in prone, supine, and flank positions.
A total number of 150 candidates for PCNL were randomly assigned into prone, supine, and flank groups. Patients in groups 1 and 2 underwent fluoroscopy-guided PCNL in prone and supine positions, respectively, while patients in group 3 underwent ultrasonography-guided PCNL in lateral position.
The success rates were 92, 86, and 88 % in prone, supine, and flank positions, respectively (P = 0.7). The mean access duration was 6.9 ± 4.2, 11.1 ± 5.8, and 10.8 ± 4.1 min (P = 0.08), and the mean operation time was 68.7 ± 37.4, 54.2 ± 25.1 and 74.4 ± 26.9 min (P = 0.04) in prone, supine, and flank groups, respectively. Pyelocaliceal perforation occurred in 2 (4 %), 2 (4 %), and 3 (6 %) patients in prone, supine, and flank positions, respectively (P = 1).
We believe that PCNL in both supine and flank positions are as safe and relatively effective as prone position in experienced hands. Preference of the surgeon and proper case selection for each procedure is very important and necessary.
比较俯卧位、仰卧位和侧卧位经皮肾镜取石术（PCNL）的安全性和疗效。
将 150 名接受 PCNL 的候选者随机分为俯卧位、仰卧位和侧卧位组。组 1 和组 2 的患者分别接受俯卧位和仰卧位的透视引导 PCNL，而组 3 的患者接受侧卧位的超声引导 PCNL。
俯卧位、仰卧位和侧卧位的成功率分别为 92%、86%和 88%（P=0.7）。入路时间的平均值分别为 6.9±4.2、11.1±5.8 和 10.8±4.1 分钟（P=0.08），手术时间的平均值分别为 68.7±37.4、54.2±25.1 和 74.4±26.9 分钟（P=0.04）。俯卧位、仰卧位和侧卧位组分别有 2（4%）、2（4%）和 3（6%）例患者发生肾盂肾盏穿孔（P=1）。
我们认为，在有经验的医生手中，仰卧位和侧卧位的 PCNL 与俯卧位一样安全且相对有效。每个手术程序的医生偏好和适当的病例选择非常重要和必要。
