Comparative study of percutaneous nephrolithotomy performed in the traditional prone position and in three different supine positions
Document title: Comparative study of percutaneous nephrolithotomy performed in the traditional prone position and in three different supine positions
Journal: International braz j urol
Database: PERIÓDICA
System number: 000434854
ISSN: 1677-5538
Authors: 1
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Institutions: 1Hospital Brigadeiro, Centro de Saude Masculina, Sao Paulo. Brasil
Year:
Season: Ene-Feb
Volumen: 45
Number: 1
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Aplicado, descriptivo
English abstract Purpose: To compare the outcomes of percutaneous nephrolithotomy (PCNL) performed in the prone position (PRON) and in three variations of the supine position. Materials and Methods: We performed a retrospective analysis of patients that underwent PCNL at our institution from June 2011 to October 2016 in PRON and in three variations of the supine position: complete supine (COMPSUP), original Valdivia (VALD), and Galdakao - modified Valdivia (GALD). All patients had a complete pre - operative evaluation, including computed tomography (CT). Success was defined as the absence of residual fragments larger than 4 mm on the first post - operative day CT. Results: We analyzed 393 PCNLs: 100 in COMPSUP, 94 in VALD, 100 in GALD, and 99 in PRON. The overall success rate was 50.9% and was similar among groups (p = 0.428). There were no differences between groups in the number of punctures, stone - free rate, frequency of blood transfusions, drop in hemoglobin level, length of hospital stay, and severe complications (Clavien ≥ 3). COMPSUP had a significantly lower operative time than the other positions. COMPSUP had lower fluoroscopy time than VALD. Conclusion: Patient positioning in PCNL does not seem to impact the rates of success or severe complications. However, COMPSUP is associated with a shorter surgical time than the other positions
Disciplines: Medicina
Keyword: Nefrología,
Cirugía,
Cálculos renales,
Nefrolitotomía percutánea,
Abordaje quirúrgico,
Posición prona
Keyword: Nephrology,
Surgery,
Kidney stones,
Percutaneous nephrolithotomy,
Surgical approach,
Prone position
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