title: Prone versus modified supine position in percutaneous nephrolithotomy: a prospective randomized study.
abstract: OBJECTIVE
  To perform a prospective randomized trial comparing the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the prone and modified supine positions.
  
  
  METHODS
  Between August 2010 and August 2011, 102 patients with renal calculi and 20 patients with ureteral calculi were randomized to undergo fluoroscopy and ultrasound-guided PCNL procedures in the prone or modified supine position. Baseline characteristics, puncture position, numbers of punctures, operation time, stone free rate, loss of blood, hospital stay and second phase PCNL were compared in the two groups.
  
  
  RESULTS
  There were no significant differences in gender, age, body mass index, stone location, stone size and the presence of hydronephrosis between the two groups. The rate of second PCNL was significantly higher and the stone clearance rate was significantly lower in the modified supine than in the prone position group. Mean operation time was significantly lower in the prone than in the modified supine position group (78 min vs 88 min, P<0.05). There were no significant differences in rates of rib and calyx puncture, numbers of punctures, mean blood loss, and mean hospital stay between the two groups.
  
  
  CONCLUSIONS
  Both the prone and modified supine positions are effective and safe for PCNL. Operation time was longer in the modified supine group, and patients undergoing PCNL in the modified supine position more frequently required a second operation due to a lower stone clearance rate.
authors.affiliation: 1. Department of Urology, First Hospital of Jilin University, 130021, Changchun, China.
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Wang
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Yunming
authors.initials: Y
authors.lastname: Yao
authors.forename: Ning
authors.initials: N
authors.lastname: Xu
authors.forename: Haifeng
authors.initials: H
authors.lastname: Zhang
authors.forename: Qihui
authors.initials: Q
authors.lastname: Chen
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Lu
authors.forename: Jinghai
authors.initials: J
authors.lastname: Hu
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Wang
authors.forename: Ji
authors.initials: J
authors.lastname: Lu
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Hao
authors.forename: Fengming
authors.initials: F
authors.lastname: Jiang
authors.forename: Yuchuan
authors.initials: Y
authors.lastname: Hou
authors.forename: Chunxi
authors.initials: C
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D016684:Prone Position; D011446:Prospective Studies; D016683:Supine Position
keywords: modified supine position; percutaneous nephrolithotomy; prone position; prospective randomized trial
references.citation: Scand J Urol Nephrol. 1976;10(3):257-9
references.pmid: 1006190
references.citation: J Endourol. 2007 Dec;21(12):1433-7
references.pmid: 18052822
references.citation: Eur Urol. 2008 Jul;54(1):196-202
references.pmid: 18262711
references.citation: J Endourol. 2011 Oct;25(10):1619-25
references.pmid: 21877911
references.citation: J Endourol. 2008 Nov;22(11):2513-7
references.pmid: 19046091
references.citation: Curr Opin Urol. 2013 Mar;23(2):164-8
references.pmid: 23357933
references.citation: BJU Int. 2007 Jul;100(1):233-6
references.pmid: 17552975
references.citation: J Endourol. 2010 Jun;24(6):931-8
references.pmid: 20345274
references.citation: Eur Urol. 2008 Dec;54(6):1262-9
references.pmid: 18707807
references.citation: J Vasc Interv Radiol. 2005 Nov;16(11):1489-92
references.pmid: 16319155
references.citation: J Endourol. 2010 Dec;24(12):1941-6
references.pmid: 20858062
references.citation: BJU Int. 2012 Dec;110(11 Pt C):E1018-21
references.pmid: 22564784
references.citation: J Urol. 1981 Apr;125(4):463-6
references.pmid: 7218439
references.citation: Urol Int. 2012;88(3):307-10
references.pmid: 22378466
references.citation: J Endourol. 2008 Dec;22(12):2665-6
references.pmid: 19025394
references.citation: Eur Urol. 2005 Jan;47(1):22-8
references.pmid: 15582245
references.citation: Urology. 2012 Jan;79(1):67-71
references.pmid: 21820700
references.citation: J Endourol. 2011 Jun;25(6):933-9
references.pmid: 21568697
references.citation: Eur Urol. 2007 Apr;51(4):899-906; discussion 906
references.pmid: 17095141
references.citation: J Urol. 1998 Dec;160(6 Pt 1):1975-8
references.pmid: 9817303
references.citation: Eur Urol. 2008 Jan;53(1):184-90
references.pmid: 17651892
references.citation: J Endourol. 2007 Jan;21(1):44-9
references.pmid: 17263606