Comparison between prone and supine nephrolithotomy in pediatric population: a double center experience

Campobasso, Davide; Bocchialini, Tommaso; Bevilacqua, L.; Guarino, Giulio; Pietro, C. Di; Granelli, Pietro; Mezzogori, Davide; Salsi, P.; Oltolina, Pietro; Gatti, Claudia; Puliatti, Stefano; Ceccarelli, Pier Luca; Maestroni, Umberto; Frattini, Antonio; Bianchi, Giampaolo; Micali, Salvatore; Ferretti, Stefania

doi:10.1007/s11255-022-03341-y

Cited by 9 publications

(11 citation statements)

References 34 publications

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“…In another study, standard and MPCNL procedures were compared in a pediatric population, and a higher Hgb decrease was noted in the standard group, although the ERT rates were similar [24]. In a cohort in which an average of 14.6-15.5 Fr access tract was used, Campobasso et al detected no signi cant difference between the supine and prone groups in terms of complications, and none of the patients required ERT [10]. In our study, the two groups were similar in terms of complication rates (16.7% vs. 16%).…”

Section: Discussionmentioning

confidence: 96%

“…In the literature, the number of studies comparing the e cacy of MPCNL in pediatric patients according to position is very limited. Campobasso et al, who performed prone and supine MPCNL on 33 and 19 pediatric patients, respectively, found a signi cantly higher SFR in the supine group (83.3% vs. 66.6%) [10]. One of the advantages of simultaneous 12/19 (63.1%) retrograde access (ECIRS) in the supine position appears to be higher stone collection.…”

Section: Discussionmentioning

confidence: 99%

“…However, despite its popularity, the prone position has certain disadvantages, including cervical spine trauma due to excessive exion-extension, limitations in ventilation due to restricted thorax movement, di culties in airway control, and challenges faced by the anesthesia team when responding to sudden events, such as cardiac arrest [7][8][9]. In contrast, PCNL performed in the supine position eliminates the need for patient repositioning and allows simultaneous retrograde access [6,10]. In addition, the airway is easily accessible during the administration of anesthesia, minimizing the risk of injury to adjacent organs during surgery [6,10].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, PCNL performed in the supine position eliminates the need for patient repositioning and allows simultaneous retrograde access [6,10]. In addition, the airway is easily accessible during the administration of anesthesia, minimizing the risk of injury to adjacent organs during surgery [6,10]. However, the number of studies comparing supine and prone positions in the pediatric age group in MPCNL in terms of surgical success and complications is quite limited [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the airway is easily accessible during the administration of anesthesia, minimizing the risk of injury to adjacent organs during surgery [6,10]. However, the number of studies comparing supine and prone positions in the pediatric age group in MPCNL in terms of surgical success and complications is quite limited [10,11]. The current study aimed to compare the e cacy and safety of MPCNL performed in the supine and prone positions in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

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A comparative analysis of the efficacy and safety of mini-percutaneous nephrolithotomy performed in the supine and prone positions for the treatment of pediatric kidney stones: a single-center experience

Bitkin,

Özlü,

Ekşi

et al. 2023

Urolithiasis

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AimMini-percutaneous nephrolithotomy (MPCNL), which has a smaller tract size (14-20 Fr) than conventional percutaneous nephrolithotomy, has been shown to be safe and effective in pediatric patients with large and complex upper urinary tract stones. This study aimed to compare the e cacy and safety of MPCNL between the supine and prone positions in a pediatric population. MethodThe data of pediatric patients who underwent MPCNL at our center between January 2010 and March 2023 were retrospectively analyzed. According to the surgical position, the patients were divided into the prone (Group P) and supine (Group S) groups. In both groups, dilatation was performed using 14-18Fr metallic dilators. The two groups were compared in terms of perioperative data, postoperative stone-free rates (SFRs), and complications. ResultsThere were 36 (59%) patients in Group P and 25 (41%) patients in Group S. Stones were mostly located in the pelvis (49.2%) and second most frequently in the lower pole (27.9%). Fluoroscopy time was shorter in Group S but did not statistically signi cantly differ compared to Group P (p = 0.181). However, operation time was statistically signi cantly shorter in Group S (73.8 ± 35 vs. 99.8 ± 37.4 min, p = 0.008). Although there was no signi cant difference, relatively higher SFR were detected in Group S (88% vs. 83%, p = 0.725). Endoscopic combined intrarenal surgery (ECIRS) was performed on six (24%) patients in Group S, and the SFR was 100% among these patients. There was no signi cant difference between the two groups in terms of the presence of complications (16.7% vs. 16%, p = 0.945). ConclusionBoth supine and prone MPCNL appear to be safe and effective in the pediatric age group, with similar stone-free and complication rates. In the supine procedure, the operation time is shortened compared to the prone. In addition, simultaneous retrograde access has the potential to increase the overall success rate of surgery.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%