title: Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones.
abstract: BACKGROUND
  Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases.
  
  
  METHODS
  Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups.
  
  
  RESULTS
  The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively (p = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group.
  
  
  CONCLUSIONS
  PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey. migokce@ankara.edu.tr.
authors.forename: Mehmet İlker
authors.initials: Mİ
authors.lastname: Gökce
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Arif
authors.initials: A
authors.lastname: Ibiş
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Sancı
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Akıncı
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Uygar
authors.initials: U
authors.lastname: Bağcı
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Eylül Asya
authors.initials: EA
authors.lastname: Ağaoğlu
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Süer
authors.affiliation: Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Gülpınar
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007670:Kidney Calices / Q000601:surgery; D008297:Male; D008875:Middle Aged; D000074642:Nephrolithotomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D056888:Patient Positioning / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D016684:Prone Position; D011446:Prospective Studies; D000069856:Staghorn Calculi; D016683:Supine Position; D016896:Treatment Outcome
keywords: Complications; Endoscopy combined intrarenal surgery; Percutaneous nephrolithotomy; Staghorn stone; Stone free rate; Supine position