How well tolerated is supine percutaneous nephrolithotomy?

Abstract:

PURPOSE OF REVIEW:Supine percutaneous nephrolithotomy (PCNL) has been described in 1988 and several modifications followed since. Despite claimed benefits, supine PCNL is still neglected by the majority of urologists. Lack of experience and the fear of complications are possible explanations for the resistance to supine positioning. This review evaluates recent literature on the use of supine PCNL, focussing on benefits and safety. RECENT FINDING:The Clinical Research Office of the Endourological Society Global Study and several (retrospective) reports comment on efficacy and safety of PCNL, differences in techniques, or identify conditions and patient factors for best practice. Anesthesiologic benefits (especially in the high risk, cardiopulmonary compromised, patient) and anatomical advantages are described in supine position theoretically favoring safety of supine PCNL. However, there are no prospective randomized studies conducted to support this assumption. Overall, benefits in efficacy or safety, of one position over the other, are not yet proven. SUMMARY:Supine PCNL has advantages in selected patients. Ultimately, the decision on position should be made on patient's characteristics and surgeon's preference and experience.

journal_name

Curr Opin Urol

authors

Baard J,Kamphuis GM,Westendarp M,de la Rosette JJ

doi

10.1097/MOU.0000000000000023

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

184-8

issue

2

eissn

0963-0643

issn

1473-6586

journal_volume

24

pub_type

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