The Effectiveness and Safety of Supine Percutaneous Nephrolithotomy in Single-Center Tertiary Hospital
DOI:
https://doi.org/10.3889/oamjms.2023.11367Keywords:
Kidney stones, Complication, Hospital stay, Stone free rate, Operation timeAbstract
ABSTRACT
Introduction : Percutaneous nephrolithotomy (PCNL) is currently recommended for patients with kidney stones larger than 20 mm. PCNL was firstly introduced in supine position in 1986. It demonstrated advantages in terms of ergonomics and shown to be less risky compared to prone position. However, there is still lack of evidence for the effectiveness nor safety of supine PCNL in Indonesia.
Objective: To analyze the effectiveness and safety of supine PCNL in single centre tertiary hospital.
Materials and Methods : 506 patients undergone supine PCNL from January 2017 to December 2021 in Dr. Kariadi general hospital were invited as sample. The retrospective data was collected from the electronic medical record system and then tabulated and analyzed using SPSS system.
Results : Out of 506 samples, the mean age was 53.19±11.82 years old with the youngest being 1 year old and the oldest being 82 years old. The stone locations were calyceal; 221 patients (43.68%), pelvis; 155 patients (30.63%), and multiple; 130 patients (25.69%). The stone size was divided into two category: >20 mm; 372 patients (73.52%) and <20 mm; 134 patients (26.48%). The mean operation time was 84±41.24 minutes with the shortest being 30 minutes and the longest being 239 minutes. Supine PCNL was performed with single puncture in 495 patients (97.83%) and with multiple punctures in 11 patients (2.17%). The total stone free rate was 95.65%. 22 patients undergone another stone removal procedures after receiving supine PCNL (2nd PCNL; 6 (1.18%), ESWL; 16 (3.16%). The mean post-operative length of hospital stay was 4.1±1.48 days with the shortest being 1 day and the longest being 8 days. 28 minor complications such as infections and blood loss were recorded with only 1 case of colon perforation which is considered to be major complication.
Conclusions : Supine PCNL in our centre is shown to have high stone free rate, short hospital stay, and low post-operative complications. These outcomes are the key component of this minimally- invasive procedure. Thus, mark the effectiveness and safety of supine PCNL in our centre.
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Cheng Y, Xu R. Effectiveness and safety of retrograde intrarenal surgery (RIRS) vs. percutaneous nephrolithotomy (PCNL) in the treatment of isolated kidney stones. Am J Transl Res. 2022;14(3):1849-58. PMid:35422937
Grosso AA, Sessa F, Campi R, Viola L, Polverino P, Crisci A, et al. Intraoperative and postoperative surgical complications after ureteroscopy (URS), retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL): A systematic review. Minerva Urol Nephrol. 2021;73(3):309-32. https://doi.org/10.23736/S2724-6051.21.04294-4 PMid:33887891 DOI: https://doi.org/10.23736/S2724-6051.21.04294-4
Kaya E, Ebiloğlu T, Zor M, Yalçın S, Coğuplugil AE, Bedir S. The outcome of percutaneous nephrolithotomy on ≥50 mm staghorn and multiple calyceal stones. Turk J Urol. 2018;44(2):148-52. http://doi.org/10.5152/tud.2017.84665 PMid:29511585 DOI: https://doi.org/10.5152/tud.2017.84665
Proietti S, Rodríguez-Socarrás ME, Eisner B, De Coninck V, Sofer M, Saitta G, et al. Supine percutaneous nephrolithotomy: Tips and tricks. Transl Androl Urol. 2019;8(Suppl 4):S381-8. http://doi.org/10.21037/tau.2019.07.09 PMid:31656744 DOI: https://doi.org/10.21037/tau.2019.07.09
Giusti G, Basulto-Martínez M, Proietti S, Saitta G, Yeow Y. Access in supine position. In: Minimally Invasive Percutaneous Nephrolithotomy. Netherlands: Springer; 2022. p. 157-64. DOI: https://doi.org/10.1007/978-981-16-6001-6_12
Hopper KD, Sherman JL, Luethke JM, Ghaed N. The retrorenal colon in the supine and prone patient. Radiology. 1987;162(2):443-6. http://doi.org/10.1148/radiology.162.2.3797658 PMid:3797658 DOI: https://doi.org/10.1148/radiology.162.2.3797658
Batagello CA, Vicentini FC, Marchini GS, Torricelli FC, Srougi M, Nahas WC, et al. Current trends of percutaneous nephrolithotomy in a developing country. Int Braz J Urol. 2018;44(2):304-13. http://doi.org/10.1590/S1677-5538.IBJU.2017.0292 PMid:29244269 DOI: https://doi.org/10.1590/s1677-5538.ibju.2017.0292
Joshi R. Complications and success rate of percutaneous nephrolithotomy in renal stone: A descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2019;57(220):444-8. http://doi.org/10.31729/jnma.4723 PMid:32335659 DOI: https://doi.org/10.31729/jnma.4723
Birowo P, Tendi W, Widyahening IS, Rasyid N, Atmoko W. Supine versus prone position in percutaneous nephrolithotomy: A systematic review and meta-analysis. F1000Res. 2020;9:231. http://doi.org/10.12688/f1000research.22940.3 PMid:33014345 DOI: https://doi.org/10.12688/f1000research.22940.3
Mandal S, Goel A, Singh MK, Kathpalia R, Nagathan DS, Sankhwar SN, et al. Clavien classification of semirigid ureteroscopy complications: A prospective study. Urology. 2012;80(5):995-1001. http://doi.org/10.1016/j.urology.2012.05.047 PMid:23107393 DOI: https://doi.org/10.1016/j.urology.2012.05.047
Safriadi F, Ramdhan D. Comparison of percutaneous nephrolitotomy (PCNL) in prone and supine position: A single centre experience report. Indones J Urol. 2021;28(1):39-43. https://doi.org/10.32421/juri.v28i1.643 DOI: https://doi.org/10.32421/juri.v28i1.643
Srinivas SU, Gall Z, Lynch N, Pollard A, Counsell A, Brown S, et al. A retrospective, observational study of supine percutaneous nephrolithotomy. J Clin Urol. 2018;11(4):285-92. https://doi.org/10.1177/2051415817731969 DOI: https://doi.org/10.1177/2051415817731969
Nualyong C, Sathidmangkang S, Woranisarakul V, Taweemonkongsap T, Chotikawanich E. Comparison of the outcomes for retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in the treatment of renal stones more than 2 centimeters. Insight Urol. 2019;40(1):9-14.
Wang F, Hong Y, Yang Z, Ye L. Comparison of retrograde intrarenal surgery and standard percutaneous nephrolithotomy for management of stones at ureteropelvic junction with high-grade hydronephrosis. Sci Rep. 2021;11(1):14050. http://doi.org/10.1038/s41598-021-93551-8 PMid:34234219 DOI: https://doi.org/10.1038/s41598-021-93551-8
Sohail N, Albodour A, Abdelrahman KM. Percutaneous nephrolithotomy in complete supine flank-free position in comparison to prone position: A single-centre experience. Arab J Urol. 2017;15(1):42-7. http://doi.org/10.1016/j.aju.2016.10.001 PMid:28275517 DOI: https://doi.org/10.1016/j.aju.2016.10.001
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Copyright (c) 2023 Muhammad Kemal Thariq Ibrahim, Nanda Daniswara, Ardy Santosa, Mohamad Adi Soedarso, Eriawan Agung Nugroho, Dimas Sindhu Wibisono, Sofyan Rais Addin (Author)
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