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Prone vs supine percutaneous nephrolithotomy: does position affect renal pelvic pressures?
Farkouh, Ala'a; Park, Kyu; Buell, Matthew I; Mack, Nicole; De Guzman, Cliff; Clark, Toby; Baldwin, Elizabeth A; Shete, Kanha; Leu, Rose; Amasyali, Akin S; Seibly, Evan; Cheng, Kai Wen; Song, Sikai; Okhunov, Zhamshid; Baldwin, D Duane.
Afiliación
  • Farkouh A; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Park K; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Buell MI; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Mack N; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • De Guzman C; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Clark T; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Baldwin EA; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Shete K; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Leu R; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Amasyali AS; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Seibly E; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Cheng KW; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Song S; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Okhunov Z; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA.
  • Baldwin DD; Department of Urology, Loma Linda University Health, Room A560, 11234 Anderson Street, Loma Linda, CA, 92354, USA. dbaldwin@llu.edu.
Urolithiasis ; 52(1): 66, 2024 Apr 17.
Article en En | MEDLINE | ID: mdl-38630256
ABSTRACT
The purpose of this study was to measure and compare renal pelvic pressure (RPP) between prone and supine percutaneous nephrolithotomy (PCNL) in a benchtop model. Six identical silicone kidney models were placed into anatomically correct prone or supine torsos constructed from patient CT scans in the corresponding positions. A 30-Fr renal access sheath was placed in either the upper, middle, or lower pole calyx for both prone and supine positions. Two 9-mm BegoStones were placed in the respective calyx and RPPs were measured at baseline, irrigating with a rigid nephroscope, and irrigating with a flexible nephroscope. Five trials were conducted for each access in both prone and supine positions. The average baseline RPP in the prone position was significantly higher than the supine position (9.1 vs 2.7 mmHg; p < 0.001). Similarly, the average RPP in prone was significantly higher than supine when using both the rigid and flexible nephroscopes. When comparing RPPs for upper, middle, and lower pole access sites, there was no significant difference in pressures in either prone or supine positions (p > 0.05 for all). Overall, when combining all pressures at baseline and with irrigation, with all access sites and types of scopes, the mean RPP was significantly higher in the prone position compared to the supine position (14.0 vs 3.2 mmHg; p < 0.001). RPPs were significantly higher in the prone position compared to the supine position in all conditions tested. These differences in RPPs between prone and supine PCNL could in part explain the different clinical outcomes, including postoperative fever and stone-free rates.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Nefrolitotomía Percutánea Límite: Humans Idioma: En Revista: Urolithiasis Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Nefrolitotomía Percutánea Límite: Humans Idioma: En Revista: Urolithiasis Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania