Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey.
Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey.
Actas Urol Esp (Engl Ed). 2022 Nov;46(9):565-571. doi: 10.1016/j.acuroe.2022.03.008. Epub 2022 Apr 28.
Although it was stated that supine percutaneous nephrolithotomy (PCNL) was associated with relatively shorter surgical times and comparable success and complication rates, there is no consensus in the current literature concerning the safety and efficacy of supine PCNL in patients with horseshoe kidneys. We aimed to compare supine and prone PCNL regarding safety and efficacy in patients with horseshoe kidneys.
Data of the patients with horseshoe kidneys who underwent PCNL for renal stones larger than 2 cm between January 2010 and May 2021 were retrospectively reviewed. The study patients were categorized as Group 1 (i.e., supine PCNL-SPCNL) and Group 2 (i.e., prone PCNL-PPCNL). Both groups were compared regarding demographic, clinical, and surgical data.
Sixty-five patients were included. Among these patients, 31 (47.7%) were in Group 1, while 34 (52.3%) were in Group 2. Both groups were statistically similar in terms of demographic data, stone characteristics, perioperative parameters, and complication rates (p > 0.05). There was no statistical difference in terms of additional treatment rates, stone-free rates in the postoperative second-day and third-month evaluations (p > 0.05). Mean surgical time was significantly longer in Group 2 (113 ± 17.1 min) than in Group 1 (90.6 ± 11.3 min) (p = 0.000).
Although it is traditionally performed in the prone position, the supine approach is as safe and effective as the prone approach. In addition, the supine approach is associated with significantly shorter surgical times.
虽然有研究表明，仰卧位经皮肾镜碎石术（PCNL）与相对较短的手术时间以及可比的成功率和并发症发生率相关，但目前文献中对于马蹄肾患者仰卧位 PCNL 的安全性和疗效尚无共识。我们旨在比较仰卧位和俯卧位 PCNL 在马蹄肾患者中的安全性和疗效。
回顾性分析 2010 年 1 月至 2021 年 5 月期间因肾结石大于 2cm 而行 PCNL 的马蹄肾患者的临床资料。将研究患者分为 1 组（即仰卧位 PCNL-SPCNL）和 2 组（即俯卧位 PCNL-PPCNL）。比较两组患者的人口统计学、临床和手术资料。
共纳入 65 例患者，其中 31 例（47.7%）患者为 1 组，34 例（52.3%）患者为 2 组。两组患者在人口统计学数据、结石特征、围手术期参数和并发症发生率方面均无统计学差异（p＞0.05）。两组患者的附加治疗率、术后第 2 天和第 3 个月结石清除率也无统计学差异（p＞0.05）。2 组的平均手术时间明显长于 1 组（113±17.1min 比 90.6±11.3min）（p=0.000）。
虽然传统上采用俯卧位，但仰卧位与俯卧位一样安全有效。此外，仰卧位还与明显较短的手术时间相关。
