title: Supplementary X-ray for ultrasound-guided percutaneous nephrolithotomy in supine position versus standard technique: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the success and complication rates of sonography-guided supine percutaneous nephrolithotomy (PCNL) versus prone standard technique (fluoroscopic guidance) in a randomized controlled trial.
  
  
  METHODS
  Between April 2009 and August 2011, 92 candidates for PCNL were randomly divided into two groups: 46 B-mode sonography-guided supine PCNL (group A) and 46 standard fluoroscopic-guided prone PCNL (group B). Demographic, clinical and perioperative patient characteristics were analyzed, and complications and success rates were compared between the two approaches.
  
  
  RESULTS
  Preoperative parameters were comparable in the two groups. The primary success rate was 79.0 and 65.2% in groups A and B, respectively, after one session of PCNL (p = 0.485). Sonography-guided access failed in 3 cases (failure rate 6.5% in group A vs. 0% in group B). Mean hospital stay (2.48 days for group A vs. 2.95 days for group B; p = 0.039) and mean nephrostomy tube stay time (1.79 days for group A vs. 2.56 days for group B; p = 0.007) were significantly prolonged in the standard technique. Postoperative fever was more prevalent in the standard PCNL group (p = 0.024), but no significant difference was observed in other complications between the two groups.
  
  
  CONCLUSIONS
  In this study, sonography-guided supine PCNL was presented as a safe and effective technique, similar to standard PCNL, with comparable success and complication rates. In addition, using this technique eliminates the possible harmful impacts of radiation on the surgical team and decreases postoperative fever.
authors.affiliation: Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Basiri
authors.forename: M A
authors.initials: MA
authors.lastname: Mirjalili
authors.forename: M
authors.initials: M
authors.lastname: Kardoust Parizi
authors.forename: N A
authors.initials: NA
authors.lastname: Moosa Nejad
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005334:Fever / Q000209:etiology / Q000517:prevention & control; D005471:Fluoroscopy; D006801:Humans; D007492:Iran; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D056888:Patient Positioning; D015641:Radiography, Interventional; D012307:Risk Factors; D016683:Supine Position; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult