Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones
Int. braz. j. urol
; 44(5): 965-971, Sept.-Oct. 2018. tab
Article
em En
| LILACS
| ID: biblio-975638
Biblioteca responsável:
BR1.1
ABSTRACT
ABSTRACT Purpose:
To evaluate the impact of the patient position on the outcomes of PCNL among patients with complex renal stones. Material andMethods:
From July 2011 to July 2014, we collected prospective data of consecutive patients who underwent PCNL. We included all patients with complex stones (Guy's Stone Score 3 or 4 (GSS) based on a CT scan) and divided them based on the position used during PCNL (prone or supine). The variables analyzed were gender, age, body mass index, ASA score, stone diameter, GSS, number of punctures, calyx puncture site, intercostal access and patient positioning. Complications were graded according to the modified-Clavien Classification. Success was considered if fragments ≤ 4mm were observed on the first postoperative day CT scan.Results:
We analyzed 240 (46.4%) of 517 PCNL performed during the study period that were classified as GGS 3-4. Regarding patient positions, 21.2% were prone and 79.8% were supine. Both groups were comparable, although intercostal access was more common in prone cases (25.5% vs 10.5%; p=0.01). The success rates, complications, blood transfusions and surgical times were similar for both groups; however, there were significantly more visceral injuries (10.3% vs 2.6%; p=0.046) and sepsis (7.8% vs 2.1%; p=0.042) in prone cases.Conclusion:
Supine or prone position were equally suitable for PCNL with complex stones and did not impact the success rates. However, supine position was associated with fewer sepsis cases and visceral injuries.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Nefrostomia Percutânea
/
Cálculos Renais
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Decúbito Dorsal
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Decúbito Ventral
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Posicionamento do Paciente
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
Idioma:
En
Revista:
Int. braz. j. urol
Ano de publicação:
2018
Tipo de documento:
Article