Lower pole stones: prone PCNL versus supine PCNL in the International Cooperation in Endourology (ICE) group experience.
World J Urol
; 31(6): 1575-80, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-23108839
ABSTRACT
PURPOSE:
To assess efficacy and safety of prone- and supine percutaneous nephrolithotomy (PCNL) for the treatment of lower pole kidney stones.METHODS:
Data from patients affected by lower pole kidney stones and treated with PCNL between December 2005 and August 2010 were collected retrospectively by seven referral centres. Variables analysed included patient demographics, clinical and surgical characteristics, stone-free rates (SFR) and complications. Statistical analysis was conducted to compare the differences for SFRs and complication rates between prone- and supine PCNL.RESULTS:
One hundred seventeen patients underwent PCNL (mean stone size 19.5 mm) for stones harboured only in the lower renal pole (single stone 53.6%; multiple stones 46.4%). A higher proportion of patients with ASA score ≥ 3 and harbouring multiple lower pole stones were treated with supine PCNL (5.8 vs. 23.1%; p = 0.0001, and 25 vs. 81.5%; p = 0.0001, respectively, for prone- and supine PCNL). One-month SFR was 88.9%; an auxiliary procedure was needed in 6 patients; the 3-month SFR was 90.2%. There were 9 post-operative major complications (7.7%). No differences were observed in terms of 1- and 3-month SFRs (90.4 vs. 87.7%; p = 0.64; 92.3 vs. 89.2%; p = 0.4) and complication rates (7.6 vs. 7.7%; p = 0.83) when comparing prone- versus supine PCNL, respectively.CONCLUSIONS:
The results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, regardless the position used. Supine PCNL was more frequently offered in case of patients at higher ASA score and in case of multiple lower pole stones.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Nefrostomía Percutánea
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Cálculos Renales
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Posición Supina
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Posición Prona
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Posicionamiento del Paciente
Tipo de estudio:
Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
World J Urol
Año:
2013
Tipo del documento:
Article
País de afiliación:
España