title: Percutaneous nephrolithotomy with ultrasonography-guided renal access in the lateral decubitus flank position.
abstract: OBJECTIVE
  Our aim was to evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with ultrasonography (US)-guided renal access in the lateral decubitus flank position.
  
  
  METHODS
  From July 2006 to March 2008, 40 patients with renal stones > 2 cm underwent PCNL with US-guided renal access in the lateral decubitus flank position by a single surgeon. We report our technique and the outcomes in detail.
  
  
  RESULTS
  Successful access was achieved in 40 patients (100%). Complete stone clearance rate was 85% (34 patients). After surgery, six (15%) patients had stones (6-11 mm) detected by plain abdominal radiography or sonography and were referred for shockwave lithotripsy. The mean stone size was 29 mm (range 22-43 mm). The mean operative time was 45 minutes (range 32-75 min), and the mean hospital stay was 2.8 days (range 2-4 d). Postoperative US did not reveal considerable fluid collection. There were no visceral injuries. Also, there was no significant bleeding that led to transfusion intraoperatively and postoperatively.
  
  
  CONCLUSIONS
  PCNL with US-guided renal access in the lateral decubitus flank position is safe and convenient, and prevents harmful effects of radiation for the surgeon, the surgical team, and the patient.
authors.affiliation: Urology and Nephrology Research Center, Tehran, Iran. karami_hosein@yahoo.com
authors.forename: Hossein
authors.initials: H
authors.lastname: Karami
authors.forename: Amir Haji Mohammad Mehdi
authors.initials: AH
authors.lastname: Arbab
authors.forename: Alireza
authors.initials: A
authors.lastname: Rezaei
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Mohammadhoseini
authors.forename: Iraj
authors.initials: I
authors.lastname: Rezaei
mesh_terms: D000328:Adult; D000368:Aged; D003710:Demography; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011187:Posture; D014463:Ultrasonography