One-Year Single Center Initial Experience of Supine PCNL

Abstract

Objectives: to study the safety and efficacy of supine position in percutaneous nephrolithotomy in treatment of large renal stones. Methods: A retrospective study included 51 patients with large renal stones (more than 2 cm) planned for PCNL operation underwent percutaneous nephrolithotomy (PCNL) in modified flank supine position from October 2022 till August 2023. We excluded from this study as uncorrectable coagulopathy, active urinary tract infection (UTI), and pediatric patients, younger than 18 years. The study protocol was approved by Damanhur National Medical Institute (HD000188/22/11/2023). Results: The most common site of stone was renal pelvis in 17 cases (33.3%) then stag horn 11 (21.6%) followed by pelvis and middle calyx 10 (19.6%). Residual stone, drop of hemoglobin, need of blood transfusion were found in 13.7%, 13.7%, 2.0% respectively. shockwave lithotripsy (SWL) and second look PCNL as auxiliary procedures were done in 15.7%, and 5.9% of patients respectively. The most postoperative complication was fever found in 3 (5.9%) of patients then hemorrhage 2 (3.9%) followed by urine leakage 1 (2.0%). Hounsfield unit, operative time and hospital stays were the most common factors predisposing to post operative complications (P