Supine Versus Prone Percutaneous Nephrolithotomy – A Randomised Comparative Study

Abstract

Percutaneous Nephrolithotomy (PCNL) is the standard procedure for large renal stones. This study was conducted to compare the conventional Prone position PCNL with the newer concept of Supine PCNL. A prospective, randomised controlled, double blind study was conducted in 100 patients planned for PCNL. They were randomised into 2 groups with 50 patients each and PCNL was performed either in the prone or supine position. The patient groups were compared for the length of hospital stay, duration of surgery, postoperative and intra operative complications, postoperative stone free status, and requirement of adjunctive procedures. Stone free rates were significantly better for the supine PCNL group. Post operative complications such as fever was more for Prone PCNL group. The other parameters that were not statistically significant were mean operating time which was less for the supine group and duration of hospital stay which was less for the supine group. There was no difference in the other complication rates between the two procedures. The requirement of additional procedures for stone clearance were also same between both the groups. To conclude, Our study demonstrates that supine PCNL is a better technique than prone PCNL in terms of stone free rates, post-operative complications such as fever, lesser number of punctures required for stone clearance and more tubeless procedures.

A new alternative to percutaneous nephrolithotomy: A case report

“…The prone position during PCNL facilitates direct access to the posterior aspect of the kidney, whereas the supine position is safer for airway management [ 14 ]. The supine position presents difficulties for surgical procedures, making the lateral decubitus position safer and more effective than both the prone and supine positions [ 15 ].…”