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Percutaneous nephrolithotomy in semisupine position: a modified approach for renal calculus

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Abstract

Conventional percutaneous nephrolithotomy (PCNL) is usually performed in a prone position, which compresses the thorax and results in difficulty in rescue during operation. When PCNL is performed in a supine position, the flank renal puncture area is limited, so it is difficult to treat disseminated and complex renal calculi. Herein, we introduce a modified semisupine position for performing PCNL, which has numerous benefits as well as safe and effective. Between May 2002 and May 2009, a total of 452 patients with renal calculi were treated with semisupine PCNL. The patient was placed in 45° semisupine position during the procedure, with the affected flank arched as much as possible. In this series, no one converted to open surgery. The average operating time was (115.2 ± 44.5) min. Single tract PCNL was performed for 80.97% of the cases, two tracts 13.94%, three tracts 4.65%, and four tracts 0.44%. The upper, middle, and lower calix tracts accounted for 12.1, 63.0, and 24.9%, of procedures, respectively. Stone-free rate was 85.7% overall, 92.2% for single calculus (83/90), and 72.9% for staghorn calculi (78/107). Major postoperative complications occurred in 3.3% of the cases. This study demonstrated PCNL in a semisupine position is an effective alternative for treating renal calculi, which combines the advantages of PCNL in a prone position, and PCNL in a supine position. The semisupine position allows easier irrigation of stone fragments, is more comfortable for the patient, and facilitates monitoring of anesthesia.

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Authors and Affiliations

  1. Department of Urology, The Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China

    Ke-wei Xu, Jian Huang, Zheng-hui Guo, Tian-xin Lin, Cai-xai Zhang, Hao Liu, Jian Chun, You-sheng Yao, Jin-li Han & Hai Huang

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  1. Ke-wei Xu
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  2. Jian Huang
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  3. Zheng-hui Guo
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  4. Tian-xin Lin
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  5. Cai-xai Zhang
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  6. Hao Liu
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  7. Jian Chun
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  8. You-sheng Yao
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  9. Jin-li Han
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  10. Hai Huang
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Correspondence to Jian Huang.

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Xu, Kw., Huang, J., Guo, Zh. et al. Percutaneous nephrolithotomy in semisupine position: a modified approach for renal calculus. Urol Res 39, 467–475 (2011). https://doi.org/10.1007/s00240-011-0366-x

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  • DOI: https://doi.org/10.1007/s00240-011-0366-x

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