Flank suspended supine position for percutaneous nephrolithotomy.
OBJECTIVE
Prone and supine positions for percutaneous nephrolithotomy are widely used but have their drawbacks. We report a new positioning method called "flank suspended supine position" (FSSP) for PCNL and describe our experience with PCNL in this position to evaluate its safety and efficacy.


METHODS
Retrospective study of 150 cases of renal stone patients treated with PCNL in a new position called flank suspended supine position (FSSP) from June 2009 to July 2010. All patients were treated with PCNL in FSSP under epidural anesthesia. Operation time, bleeding rate, stone free rate, and complications were recorded.


RESULTS
All patients tolerated FSSP. Mean operation time was 78.29±26.13 min. Initial stone-free rate was 83%. For those with residual stones (26 cases), 18 were stone-free after a second PCNL, 8 after extracorporeal shock wave lithotripsy (ESWL). Mean hospital stay was 7.63±2.39 days. No penetrating injury of the pleural cavity or injury to visceral organs was reported.


CONCLUSIONS
FSSP is an effective and safe position for PCNL in our hands and its effectiveness relative to traditional prone position needs to be determined in future randomized studies.
Department of Urological Surgery, Wuhan General Hospital of Guangzhou Command of PLA, Wuhan, China.
Tie-jun
TJ
Pan
Gong-cheng
GC
Li
Zhang-qun
ZQ
Ye
Han-dong
HD
Wen
Guo-qiu
GQ
Shen
Jia-qiao
JQ
Zhang
D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007668:Kidney / Q000002:abnormalities; D007669:Kidney Calculi / Q000601:surgery; D007902:Length of Stay; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D061646:Operative Time; D056888:Patient Positioning; D012189:Retrospective Studies; D015607:Stents; D016683:Supine Position