World Journal of Laparoscopic Surgery

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VOLUME 16 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

Our Experience with Flank-free Modified Supine Percutaneous Nephrolithotomy

Mufti Mahmood Ahmed, Nasir Hamid Bhat, Irshad Ahmad Kumar, Fayaz Ahmad Najar

Keywords : Flank-free, Nephrolithiasis, Percutaneous nephrolithotomy

Citation Information : Ahmed MM, Bhat NH, Kumar IA, Najar FA. Our Experience with Flank-free Modified Supine Percutaneous Nephrolithotomy. World J Lap Surg 2023; 16 (3):137-141.

DOI: 10.5005/jp-journals-10033-1583

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Objective: The objective of this study was to evaluate the safety profile and efficacy of “flank-free modified supine position (FFMS)” approach for percutaneous nephrolithotomy (PCNL). Materials and methods: This study was conducted in the Department of General Surgery over 4-year period from August 2016 to August 2020 on 50 patients after institutional ethical clearance. Results: The patients in our study were in the range of 21–65 years with mean age of 35.9 SD 9.85 years. Approximately, 62% of patients were males and right kidney was involved in 54%. The mean stone size of our study group was 17.3 SD 1.81 mm with a range of 14.2–21 mm. Pelvic stones were found in 28 (56%) of patients and majority of our patients, i.e., 88% were symptomatic of their disease. The mean operative time in our study was 83.62 SD 16.95 with range of 60–115 minutes. Nephrostomy was placed in situ in 84% patients. There was no operation related mortality in our study. The mean hospital stay of our patients was 3.7 SD 1.15 days. Out of total 50 patients, success was achieved in 45 (90%) patients as 6% required auxiliary treatment and 4% was converted to prone position. Conclusion: Thus, in our study we found that FFMS PCNL surgery is a safe and an effective means of intrarenal access with high success rate and with acceptable morbidity and complications.


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  1. Modlin M. A history of urinary stone. S Afr Med J 1980;58(16):652–655. PMID: 6999641.
  2. Goodwin WE, Casey WC, Wolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955;157(11): 891–894. DOI: 10.1001/jama.1955.02950280015005.
  3. Wolf JS Jr. Percutaneous approaches to the upper urinary tract collecting system. Campbell-Walsh Urology by Alan J Wein, Louis R Kavoussi, 11th Edition. pp. 153–182.
  4. Autorino R, Giannarini G. Prone or supine: Is this the question? Eur Urol 2008;54(6):1216–1218. DOI: 10.1016/j.eururo.2008.08.069.
  5. Valdivia UJG, Valle Gerhold J, Lopez JA, et al. Technique and complications of percutnaeous nephroscopy: Experience with 557 patients in the supine position. J Urol 1998;160(6.1):1975–1978. DOI: 10.1016/s0022-5347(01)62217-1.
  6. De Sio M, Autorino R, Quarto G, et al. Modified supine versus prone position in percutaneous nephrolithotomy for renal stones treatable with single percutaneous access: A prospective randomized trial. Eur Urol 2008;54(1):196–202. DOI: 10.1016/j.eururo.2008.01.067.
  7. Ray AA, Chung DG, Honey RJ. Percutaneous nephrolithotomy in prone and prone flexed positions: Anatomic considerations. J Endoruol 2009;23(10):1607–1614. DOI: 10.1089/end.2009.0294.
  8. Desoky EAE, Allam MN, Ammar MK, et al. Flank free modified supine position: A new modification for supine percutaneous nephrolithotomy. Arab J Urol 2012;10(2):143–148. DOI: 10.1016/j.aju.2011.12.008.
  9. Karami H, Arbab AH, Rezaei A, et al. Percutaneous nephrolithotomy with ultrasonography-guided renal access in the lateral decubitus flank position. J Endourol 2009;23(1):33–35. DOI: 10.1089/end.2008.0433.
  10. Lehman T, Bagley DH. Reverse lithotomy, modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women. Urology 1988;32(6):529–531. DOI: 10.1016/s0090-4295(98) 90035-8.
  11. Desoky E, Abd Elwahab KM, El-Babouly IM, et al. Outcomes of flank-free modified supine percutaneous nephrolithotomy based on BMI. Urol Int 2021;105(1–2):77–82. DOI: 10.1159/000511292.
  12. Nour HH, Kamal AM, Ghobashi SE, et al. Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience. Arab J Urol 2013;11(1):62–67. DOI: 10.1016/j.aju.2012.12.007.
  13. Miçooğulları U, Kamacı D, Yıldızhan M, et al. Prone versus Barts “flank-free” modified supine percutaneous nephrolithotomy: A match-pair analysis. Turk J Med Sci 2021;51(3):1373–1379. DOI: 10.3906/sag-2011-21.
  14. Wang Y, Hou Y, Jiang F, et al. Percutaneous nephrolithotomy for staghorn stones in patients with solitary kidney in prone position or in completely supine position: A single-center experience. Int Braz J Urol 2012;38(6):788–794. DOI: 10.1590/1677-553820133806788.
  15. Neto EA, Mitre AI, Gomes CM, et al. Percutaneous nephrolithotripsy with the patient in a modified supine position. J Urol 2007;178(1): 165–168. DOI: 10.1016/j.juro.2007.03.056.
  16. Abdel-Mohsen E, Kamel M, Zayed AL, et al. Free-flank modified supine vs. prone position in percutaneous nephrolithotomy: A prospective randomised trial. Arab J Urol 2013;11(1):74–78. DOI: 10.1016/j.aju.2012.11.002.
  17. Tefekli A, Karadag MA, Tepeler K, et al. Classification of percutaneous nephrolithotomy complications using the modified Clavien grading system: Looking for a standard. Eur Urol 2008;53(1):184–190. DOI: 10.1016/j.eururo.2007.06.049.
  18. Hoznek A, Rode J, Quzaid I, et al. Modified supine percutaneous nephrolithotomy for large kidney and ureteral stones: Technique and results. Eur Urol 2012;61(1):164–170. DOI: 10.1016/j.eururo.2011. 04.031.
  19. Falahatkar S, Allahkhan A, Soltanipour S. Supine percutaneous nephrolithotomy: PRO. Urol J 2011;8(4):257–264. PMID: 22090042.
  20. Perrella R, Vicentini FC, Paro ED, et al. Supine versus prone percutaneous nephrolithotomy for complex stones: A multicenter randomized controlled trial. J Urol 2022;207(3):647–656. DOI: 10.1097/JU.0000000000002291.
  21. De Sio M, Autorino R, Quarto G, et al. Modified supine versus prone position in percutaneous nephrolithotomy for renal stones treatable with a single percutaneous access: A prospective randomized trial. Eur Urol 2008;54(1):196–203. DOI: 10.1016/j.eururo.2008.01.067.
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