Kiss Zoltán, Drabik Gyula, Murányi Mihály, Nagy Attila, Goumas Ioannis Kartalas, Flaskó Tibor
Department of Urology, University of Debrecen, 4032 Debrecen, Hungary.
Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary.
Medicina (Kaunas). 2025 Apr 18;61(4):748. doi: 10.3390/medicina61040748.
To evaluate the effectiveness and outcomes of supine percutaneous nephrolithotomy (PCNL) using the Barts 'flank-free' position and ultrasound-guided puncture, assessing the feasibility of the tubeless technique for discharge within 24 h. We conducted a retrospective analysis of 208 patients across 220 renal units who underwent supine PCNL at a tertiary university hospital between May 2019 and December 2024. All procedures were performed by a single surgeon. Patient demographics, stone characteristics, and surgical outcomes were analyzed. The tubeless technique was applied in most cases, and outcomes were assessed in terms of operative time, complication rates, stone-free rates (SFRs), and length of hospital stay. The mean operating time was 50.34 ± 30.80 min. Single-tract PCNL was performed in 94.55% of cases, with the tubeless technique used in 90% of patients. The overall complication rate was 9.55%, with no Clavien-Dindo grade IV-V complications observed. On the first postoperative day, 68.18% of patients were discharged, demonstrating 24 h discharge feasibility. SFR and complication rates aligned with existing literature. The Barts 'flank-free' position and ultrasound-guided puncture considerably improved surgical access and safety in supine PCNL. The tubeless technique facilitates faster recovery, making early discharge feasible, even with standard sheath sizes. Further research is warranted to validate these findings and optimize renal stone management outcomes.
为评估采用巴茨“无侧腹”体位及超声引导穿刺进行仰卧位经皮肾镜取石术（PCNL）的有效性和结果，评估无管技术在24小时内出院的可行性。我们对2019年5月至2024年12月期间在一家三级大学医院接受仰卧位PCNL的220个肾单位的208例患者进行了回顾性分析。所有手术均由一名外科医生进行。分析了患者的人口统计学资料、结石特征和手术结果。大多数病例采用无管技术，并从手术时间、并发症发生率、结石清除率（SFR）和住院时间方面评估结果。平均手术时间为50.34±30.80分钟。94.55%的病例采用单通道PCNL，90%的患者使用无管技术。总体并发症发生率为9.55%，未观察到Clavien-Dindo IV-V级并发症。术后第一天，68.18%的患者出院，证明了24小时出院的可行性。SFR和并发症发生率与现有文献一致。巴茨“无侧腹”体位及超声引导穿刺显著改善了仰卧位PCNL的手术入路和安全性。无管技术有助于更快恢复，即使使用标准鞘管尺寸也能实现早期出院。有必要进行进一步研究以验证这些发现并优化肾结石治疗结果。
