title: Free-flank modified supine vs. prone position in percutaneous nephrolithotomy: A prospective randomised trial.
abstract: OBJECTIVE
  To compare the technical aspects, operative time, safety and effectiveness of percutaneous nephrolithotomy (PCNL) in the free-flank modified supine position (FFMSP) vs. the standard prone position (SPP).
  
  
  METHODS
  Seventy-seven patients (47 men and 30 women) with renal stones were enrolled and systematically randomised into two groups, A (39 patients) treated using the FFMSP, and B (38 patients) in the SPP. The outcome was considered as a cure (successful procedure) if the patient became stone-free or had residual fragments of <4 mm in diameter. The operative time (from the induction of anaesthesia to the removal of the endotracheal tube) was measured and any operative complications or conflicts were recorded. The different variables were compared and analysed between the groups.
  
  
  RESULTS
  Patients in both groups had comparable preoperative clinical data and there were no significant differences in the preoperative clinical characteristics. The procedure was successful in 84.6% and 84% of group A and B, respectively. The operative time was significantly longer in group B (SPP) than A (FFMSP). There was no significant difference between the groups in fluoroscopy time and patients' outcome.
  
  
  CONCLUSIONS
  The FFMSP (with a cushion under the ipsilateral shoulder) has similar efficacy and safety as the SPP for PCNL and is associated with a significantly quicker operation.
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Essam
authors.initials: E
authors.lastname: Abdel-Mohsen
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Kamel
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Abdel-Latif
authors.initials: AL
authors.lastname: Zayed
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Emad A
authors.initials: EA
authors.lastname: Salem
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Ehab
authors.initials: E
authors.lastname: Ebrahim
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Khalid
authors.initials: K
authors.lastname: Abdel Wahab
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elaymen
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Shaheen
authors.affiliation: Department of Urology, Zagazig University, Zagazig, Egypt.
authors.forename: Hussien M
authors.initials: HM
authors.lastname: Kamel
keywords: BMI, body mass index; FFMSP, free-flank modified supine position; PCNL, percutaneous nephrolithotomy; Percutaneous nephrolithotomy; Position; Prone; SPP, standard prone position; Stones; Supine