Comparison on efficacy and safety of percutaneous nephrolithotomy for the treatment of renal stones:modified supine Valdivia versus prone position
10.3760/cma.j.issn.1000-6702.2015.06.002
- VernacularTitle:改良 Valdivia 体位和俯卧位经皮肾镜取石术治疗肾结石的疗效和安全性比较
- Author:
Shuigen ZHOU
;
Ling WANG
;
Xiaofeng XU
;
Longxin WANG
;
Jie DONG
;
Kai ZHOU
;
Zhengyu ZHANG
- Publication Type:Journal Article
- Keywords:
Nephrostomy,percutaneous;
Supine position;
Prone position;
Retrospective studies
- From:
Chinese Journal of Urology
2015;(6):405-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of percutaneous nephrolithotomy ( PCNL) in modified supine Valdivia and traditional prone positions for the treatment of renal stones.Methods Clinical data of 80 consecutive patients with renal calculi who accepted PCNL from December 2012 to September 2014 were retrospectively reviewed.They were divided into modified supine Valdivia group ( n=44) and prone position group (n=36) according to the position during surgery.There was no significant difference between the 2 groups in age, sex, ASA class, stone location and size (P>0.05).Total operative time, ratio of multi-access, blood loss, perioperative complications and stone-free rate were compared between the 2 groups.Results All punctures were performed successfully.No case was converted to open surgery.No severe complications such as colon injury, pleura or peritoneum perforation, or death occurred intra-and post-operatively.In prone position, 1 patient was found to develop high intra-trachea pressure because of large stone burden and prolonged operative time (130 min).This procedure was stopped and the patient received the second session of PCNL 1 week later.The mean total operative time was significantly shorter in the modified supine than in the prone position ( 67.7 ±24.5 min versus 91.5 ±29.8 min, P<0.05).There were no significant differences in ratio of multi-access (14% versus 22%), mean blood loss (1.3 ±0.2 g/L versus 1.4 ±0.7 g/L), incidence of complications (18% versus 19%), and stone clearance rate ( 80% versus 86%) between the 2 groups ( P >0.05 ) .Conclusion PCNL in modified supine Valdivia is as safe and effective as that of prone position for the treatment of renal stones, but the former is more time-saving than the latter.
