Percutaneous Nephrolithotomy, Renal Stones, Ultrasound Therapy; Complications
Conditions
Brief summary
The aim of this study is to compare the effectiveness of Ultrasound-Guided Percutaneous nephrolithotomyin different positions supine, prone positions and flank suspend supine position in renal stones treatment.
Detailed description
Percutaneous nephrolithotomy (PCNL) has become the choice of modality for the treatment of large and complicated renal calculi. Initially, percutaneous access to the kidney was only performed in the prone position, as described sixty years ago.
Interventions
PROCEDUREFlank suspended supine position percutaneous nephrolithotomy
The patients will be placed in the supine position with the shoulder and the buttock will be raised by a 3-l bag of water suspending the flank of the affected side. The body contour will be aligned to the edge of the table. The operating table will be adjusted to the jack knife position, with the tip of the lower part of the table will be slightly lowered. The leg of the affected side of the patent will be straightened dorsally flexed and slightly inner rotated, with the knee of the other side will be flexed. The patients will be then immobilized at the chest and the pelvis with two adherent tapes which crossed each other at the abdomen to form a 'V' shape.
PROCEDURESupine percutaneous nephrolithotomy group
The patient will remain in the supine position, with the side of interest at the edge of the table, with a small cushion placed under the flank to elevate it 15-20°.
PROCEDUREProne percutaneous nephrolithotomy group
Prone percutaneous nephrolithotomy. The prone position (PRON) technique followed these classic steps: patients will be placed in a lithotomy position and a ureteral catheter will be inserted through a rigid cystoscope to perform a retrograde pyelogram. The ureteral catheter will be fixed to a Foley catheter, and then the patient will be repositioned to the prone position with pads under their shoulders.
Sponsors
Benha University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* patients who underwent Percutaneous nephrolithotomy * Patient's age from \>18 - 70 years old. * Body mass index (30-40 kg/m2). * Both sex * Renal stones diameter ≥2 cm * Cardiac patients
Exclusion criteria
* Patient refusal. * Pregnant women. * Patients with renal anomalies. * Transplanted kidney. * Uncorrected coagulopathy, or active infection.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stone clearance rate | 3 months postoperatively | Comparison of stone clearance rates among different positions (flank suspended supine, supine, and prone) in Ultrasound-Guided Percutaneous Nephrolithotomy (PCNL) for the treatment of renal stones. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operative time | Intraoperatively | duration of the Ultrasound-Guided Percutaneous Nephrolithotomy (PCNL) procedure among different positions |
| Complication rates | 48 hours Postoperatively | Comparison of postoperative complications (e.g., bleeding, infection, injury) among the different positions. |
| Stone-free rates | 48 hours Postoperatively | Comparison of the percentage of patients achieving complete stone clearance among the different positions. |
Countries
Egypt
Outcome results
None listed