Department of Urology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India.
Urologia. 2024 Aug;91(3):558-562. doi: 10.1177/03915603241229801. Epub 2024 Mar 18.
Compare the surgical outcomes, safety, stone free rate, hospital stay, and complication of prone and supine PCNL in case of complex renal stone.
This is an observational study conducted in our institute, it consist of 120 patients over the period of 2 years from July 2021 to June 2023, all the patients were divided into two groups: 60 patients underwent modified supine percutaneous nephrolithotomy (PCNL) and remaining 60 patients underwent standard prone PCNL. The measured data included operative time, number of punctures, blood loss, stone-free rate, length of hospital stays, and rate of complications.
The two groups were comparable in mean age, male to female ratio, number of punctures, number of tract, size of tract, residual calculi in follow up period, blood transfusion, re-do surgery, chest complication, hospital stay, and postoperative fever and pain. The mean operating time was 1.59 h in supine PCNL and 2.49 h in prone PCNL. The value was significant ( = 0.001).
By this study we observed that the supine PCNL is associated with statistically significant reduced operating time as compared to conventional prone PCNL with advantages of not putting the patient in prone position. The postoperative complications such as pain and fever were not significant when compared in both groups. We conclude our study and found that, the supine PCNL is an equally effective in treating complex renal stone as compared to prone PCNL.
比较复杂肾结石患者俯卧位和仰卧位经皮肾镜取石术(PCNL)的手术结果、安全性、结石清除率、住院时间和并发症。
这是一项在我院进行的观察性研究,共纳入 120 例患者,时间跨度为 2021 年 7 月至 2023 年 6 月。所有患者分为两组:60 例行改良仰卧位 PCNL,60 例行标准俯卧位 PCNL。测量的数据包括手术时间、穿刺次数、出血量、结石清除率、住院时间和并发症发生率。
两组在平均年龄、男女比例、穿刺次数、通道数量、通道大小、随访期残余结石、输血、再次手术、胸部并发症、住院时间以及术后发热和疼痛方面无显著差异。仰卧位 PCNL 的平均手术时间为 1.59 小时,俯卧位 PCNL 为 2.49 小时。差异具有统计学意义(=0.001)。
通过本研究,我们观察到与传统俯卧位 PCNL 相比,仰卧位 PCNL 具有统计学上显著缩短的手术时间优势,同时避免了患者处于俯卧位。两组患者术后并发症如疼痛和发热无显著差异。我们的研究结果表明,仰卧位 PCNL 在治疗复杂肾结石方面与俯卧位 PCNL 同样有效。