The significance of position in percutaneous nephrolithotomy

Aim: Percutaneous nephrolithotomy (PNL) can be performed in both prone and supine positions. In this study, we aimed to compare prone and supine PNL in terms of efficiency and safety. Material and Methods: The study included 94 patients (group-1) who underwent supine PNL and 93 patients (group-2) who underwent prone PNL between February 2018 and June 2020. Group-1 and group-2 were divided into two groups. Group-1A were patients who underwent supine mini-PNL, group-1B patients who underwent supine standard-PNL, Group-2A patients who underwent prone mini-PNL, and Group-2B Patients who underwent prone standard-PNL. Then, demographic characteristics, operative data, and postoperative parameters of all these groups were examined among themselves. Results: Mini-percutaneous nephrolithotomy was performed in 81.9% of the patients in the supine position and 57% of the patients in the prone position, and a statistically significant difference was observed (p:<0.001). There was no significant difference in terms of success and complications in mini percutaneous nephrolithotomy. In standard percutaneous nephrolithotomy, while the success was 29.4% in the supine position, it was 60% in the prone position, and a statistically significant difference was observed (p:0.035). There was no significant difference in complications. Conclusion: Supine mini-PNL and prone mini-PNL have similar success and complication rates. As a result of increasing experience in the supine position, our standard PNL rate gradually decreased and it was seen that mini-PNL was mostly performed. İt is the most appropriate approach to decide which positional technique should be performed by considering the patient's characteristics and the surgeon's experience. KEYWORDS: Supine Percutaneous Nephrolithotomy, Prone Percutaneous Nephrolithotomy