Supine percutaneous nephrolithotomy, is it really effective? A systematic review of literature.
BACKGROUND
This systematic review was performed to determine the clinical value of percutaneous nephrolithotomy in the supine position in comparison with the convention of performing the procedure in the prone position.


METHODS
A systematic review of the medical literature was conducted searching for studies on percutaneous nephrolithotomy in the supine position, limited to publications appeared in the PubMed between 1980 and July 2008. Non-English articles were considered if deemed relevant by providing additional data. In the retrieved articles, reference lists were hand-searched to identify additional relevant articles.


RESULTS
There were 9 original articles on percutaneous nephrolithotomy in the supine position. Five studies were retrospective and 4 were prospective, of which only 1 was a well-designed randomized controlled trial published in 2008. The success rate of the procedure was reported between 69.6% and 95%. The risk of requiring blood transfusion was between zero and 8%. Duration of hospital stay was variable, but generally less than that in the prone position. No colon perforation was reported.


CONCLUSIONS
In carefully selected patients with uncomplicated urinary calculi, percutaneous calculus removal in the supine position can yield similar outcomes to that in the prone position.
Basiri
Abbas
A
Department of Urology, Shahid Labbafinejad Medical Center and Urology and Nephrology Research Center, Shahid Beheshti University (MC), Tehran, Iran.
Mohammadi Sichani
Mehrdad
M
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D053040:Nephrolithiasis / Q000175:diagnosis / Q000601:surgery*; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000503:physiopathology; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016683:Supine Position; D016896:Treatment Outcome