[Comparison the effects of prone and modified recumbent positions on minimal invasive percutaneous nephrolithotomy].

ABSTRACT

OBJECTIVE: To compare the safety and efficacy of prone and modified recumbent positions on minimal invasive percutaneous nephrolithotomy. METHODS: A total of 62 patients with upper urinary calculi were grouped into two groups, one of which consisted of 27 patients who underwent the minimal invasive percutaneous nephrolithotomy with modified recumbent position, and the other 35 patients with prone position. There was no significant statistical difference in the age, gender and complications between the two groups before surgery (P>0.05). Duration of and blood loss during surgery, complications in the perioperative period, and the length of postoperative hospital stay were all recorded. The data were analyzed by SPSS 13.0. RESULTS: Surgery was successful in all cases. There was no failure to puncture nor need to resort to open surgery. Average operation duration for the modified recumbent position group was (85.1± 25.3) min vs (97.2±30.6) min for the prone position group. Mean blood loss during the operation was (117.5± 49.7) mL vs (149.3±53.1) mL. There were no severe complications during and after surgery in the modified recumbent position group. In the prone position group, s one patient suffered pneumothorax during the operation and two suffered selective renal artery embolization because of massive hemorrhaging following the operation. There were significant differences in blood loss during surgery, in complications during the perioperative period, and in length of postoperative stay in hospital (P<0.05) between the two groups. CONCLUSION: The patients are safer and more easily tolerate the minimal invasive percutaneous nephrolithotomy in the modified recumbent position than in the prone position, though the treatment efficacy of these two kinds of operation is similar. It is recommended that the modified recumbent position should be used generally in the percutaneous nephrolithotomy.