Lower pole stones: prone PCNL versus supine PCNL in the International Cooperation in Endourology (ICE) group experience

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• 作者：Francesco Sanguedolce (1)
  Alberto Breda (1)
  Felix Millan (1)
  Marianne Brehmer (2)
  Thomas Knoll (3)
  Evangelos Liatsikos (4)
  Palle Osther (5)
  Olivier Traxer (6)
  Cesare Scoffone (7)
  
• 关键词：Percutaneous nephrolithotripsy ; Prone ; and supine PCNL ; Lower pole kidney stones ; Urolithiasis
• 刊名：World Journal of Urology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：31
• 期：6
• 页码：1575-1580
• 全文大小：
• 作者单位：Francesco Sanguedolce (1)
  Alberto Breda (1)
  Felix Millan (1)
  Marianne Brehmer (2)
  Thomas Knoll (3)
  Evangelos Liatsikos (4)
  Palle Osther (5)
  Olivier Traxer (6)
  Cesare Scoffone (7)
  
  1. FundaciPuigvert, Department of Urology, Autonomous University of Barcelona, C/Cartagena 340-350, 08026, Barcelona, Spain
  2. Department of Urology, Karolinska University Hospital, Stockholm, Sweden
  3. Department of Urology, Klinikum Sindelfingen, University of Tingen, Tingen, Germany
  4. Department of Urology, Patras University, Patras, Greece
  5. Department of Urology, Frederica Hospital, University of Southern Denmark, Fredericia, Denmark
  6. Department of Urology, Tenon Hospital, 6th University of Paris, Paris, France
  7. Department of Urology, Cottolengo Hospital, Turin, Italy
  
• ISSN：1433-8726

文摘

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: 19.5mm) for stones harboured only in the lower renal pole (single stone: 53.6%; multiple stones: 46.4%). A higher proportion of patients with ASA score3 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.