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01-12-2013 | Original Article

Lower pole stones: prone PCNL versus supine PCNL in the International Cooperation in Endourology (ICE) group experience

Authors: Francesco Sanguedolce, Alberto Breda, Felix Millan, Marianne Brehmer, Thomas Knoll, Evangelos Liatsikos, Palle Osther, Olivier Traxer, Cesare Scoffone

Published in: World Journal of Urology | Issue 6/2013

Abstract

Purpose

To assess efficacy and safety of prone- and supine percutaneous nephrolithotomy (PCNL) for the treatment of lower pole kidney stones.

Methods

Data from patients affected by lower pole kidney stones and treated with PCNL between December 2005 and August 2010 were collected retrospectively by seven referral centres. Variables analysed included patient demographics, clinical and surgical characteristics, stone-free rates (SFR) and complications. Statistical analysis was conducted to compare the differences for SFRs and complication rates between prone- and supine PCNL.

Results

One hundred seventeen patients underwent PCNL (mean stone size: 19.5 mm) for stones harboured only in the lower renal pole (single stone: 53.6 %; multiple stones: 46.4 %). A higher proportion of patients with ASA score ≥ 3 and harbouring multiple lower pole stones were treated with supine PCNL (5.8 vs. 23.1 %; p = 0.0001, and 25 vs. 81.5 %; p = 0.0001, respectively, for prone- and supine PCNL). One-month SFR was 88.9 %; an auxiliary procedure was needed in 6 patients; the 3-month SFR was 90.2 %. There were 9 post-operative major complications (7.7 %). No differences were observed in terms of 1- and 3-month SFRs (90.4 vs. 87.7 %; p = 0.64; 92.3 vs. 89.2 %; p = 0.4) and complication rates (7.6 vs. 7.7 %; p = 0.83) when comparing prone- versus supine PCNL, respectively.

Conclusions

The results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, regardless the position used. Supine PCNL was more frequently offered in case of patients at higher ASA score and in case of multiple lower pole stones.

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Title: Lower pole stones: prone PCNL versus supine PCNL in the International Cooperation in Endourology (ICE) group experience
Authors: Francesco Sanguedolce
Alberto Breda
Felix Millan
Marianne Brehmer
Thomas Knoll
Evangelos Liatsikos
Palle Osther
Olivier Traxer
Cesare Scoffone
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 6/2013
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-012-0941-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Lower pole stones: prone PCNL versus supine PCNL in the International Cooperation in Endourology (ICE) group experience

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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