Document Detail


Percutaneous nephrolithotomy in the supine position: a neglected approach?
MedLine Citation:
PMID:  18052822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of the study was to demonstrate the safety and effectiveness of single-stage percutaneous nephrolithotomy performed in the supine position. PATIENTS AND METHODS: A single surgeon performed 322 consecutive percutaneous nephrolithotomies in patients in the supine position between 1999 and 2006, which were studied prospectively. RESULTS: There were no complications related to the supine position, and in only one patient was there failed access. This patient's kidney was subsequently punctured with the patient in the supine position. There were no colonic injuries, no pneumothoraces, and a transfusion rate of 3.7%. Surgery on all patients with stones, including staghorn calculi and bilateral stones managed synchronously, was in the supine position. The median time to percutaneous access in a timed cohort of 27 patients was 5 minutes. The stone clearance rate was 91%. The median length of hospital stay was reduced from 6 days in the initial unstented patients to 3 days in the study overall when most patients received stents. CONCLUSIONS: Percutaneous nephrolithotomy in the supine position is safe, effective, and suitable for the majority of patients. It offers the potential advantages of better urethral access, less patient handling, and the need to only drape once, thus reducing the overall operative time compared to the traditional prone position.
Authors:
Denby Steele; Villis Marshall
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  21     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-01-11     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1433-7     Citation Subset:  IM    
Affiliation:
Urology Unit, Department of Surgical Services, Royal Adelaide Hospital, South Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cystoscopy / methods
Female
Follow-Up Studies
Humans
Kidney Calculi / diagnosis,  surgery*
Male
Middle Aged
Nephrostomy, Percutaneous / methods*
Prospective Studies
Supine Position*
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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