Department of Urology, University of Cagliari, Via Is Mirrionis 92, 09121, Cagliari, Italy.
Urolithiasis. 2020 Feb;48(1):63-69. doi: 10.1007/s00240-018-1088-0. Epub 2018 Nov 19.
The study was performed to evaluate the efficacy of our modified supine position (called "Double-S") in percutaneous nephrolithotripsy (PCNL) and to make a contribution to the question: "Is there a better position in PCNL?". The superiority of one position is still under debate in the scientific community. In our study, we described and compared our position with the standard prone one to evaluate the possible benefits. This is a prospective randomized clinical trial conducted for 17 months. It consisted of two sub-studies: trial A (patients with stones approachable with a single anterograde access) and trial B (patients with stones approachable with a single anterograde access combined with a retrograde access). A 1:1 randomization was performed in both trials to compare the supine Double-S position with the prone one. We found that the Double-S position presents the same safety and efficacy outcomes as the standard prone one. Moreover, we proved that this particular position can reduce the patient positioning time and effort sustained by professional nurses if compared to the prone one. The same outcomes were found in trial A and in trial B. Trial B confirms the efficacy of our position also when a combined access is needed. We proved that the Double-S position is safe and effective both in anterograde treatments and in combined anterograde-retrograde procedures with benefits in the positioning time and effort level.
本研究旨在评估我们改良的仰卧位（称为“双 S 位”）在经皮肾镜碎石取石术（PCNL）中的疗效，并为“PCNL 中是否存在更好的体位”这一问题提供答案。一种体位的优越性在科学界仍存在争议。在本研究中，我们描述并比较了我们的体位与标准俯卧位，以评估可能的优势。这是一项为期 17 个月的前瞻性随机临床试验。它包括两个子研究：试验 A（可通过单一顺行通道到达的结石患者）和试验 B（可通过单一顺行通道和逆行通道到达的结石患者）。在两个试验中均进行了 1:1 随机分组，以比较仰卧位双 S 位与俯卧位。我们发现，双 S 位与标准俯卧位具有相同的安全性和疗效。此外，与俯卧位相比，我们证明该特定体位可以减少专业护士的患者定位时间和体力消耗。在试验 A 和试验 B 中均得出了相同的结果。试验 B 还证实了我们的体位在需要联合通道时的疗效。我们证明，双 S 位在顺行治疗和联合顺行-逆行手术中均安全有效，在定位时间和体力消耗方面具有优势。
