Effectiveness of US-Guided PCNL Different Positions in Renal Stones Treatment

A Retrospective Single Centered Cohort Study Comparing The Effectiveness of Ultrasound-Guided PCNL Different Positions in Renal Stones Treatment

The aim of this study is to compare the effectiveness of Ultrasound-Guided Percutaneous nephrolithotomyin different positions supine, prone positions and flank suspend supine position in renal stones treatment.

Study Overview

• Status: Completed
• Conditions: Renal Stones; Ultrasound Therapy; Complications; Percutaneous Nephrolithotomy
• Intervention / Treatment: Procedure: Flank suspended supine position percutaneous nephrolithotomy; Procedure: Supine percutaneous nephrolithotomy group; Procedure: Prone percutaneous nephrolithotomy group

Detailed Description

Percutaneous nephrolithotomy (PCNL) has become the choice of modality for the treatment of large and complicated renal calculi. Initially, percutaneous access to the kidney was only performed in the prone position, as described sixty years ago.

• Study Type: Observational
• Enrollment (Actual): 123

Contacts and Locations

Study Locations

• Egypt
  • Benha, Egypt
    • Benha University Hospitals

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

123 patients who underwent Percutaneous nephrolithotomy at the period from 2018 to 2022 and were diagnosed with consecutive, adult obese patients (age >18-70 years) with renal stones diameter ≥2 cm

Description

Inclusion Criteria:

• patients who underwent Percutaneous nephrolithotomy
• Patient's age from >18 - 70 years old.
• Body mass index (30-40 kg/m2).
• Both sex
• Renal stones diameter ≥2 cm
• Cardiac patients

Exclusion Criteria:

• Patient refusal.
• Pregnant women.
• Patients with renal anomalies.
• Transplanted kidney.
• Uncorrected coagulopathy, or active infection.

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Flank suspended supine position percutaneous nephrolithotomy; This group included 41 patients in flank suspended supine position percutaneous nephrolithotomy.	Procedure: Flank suspended supine position percutaneous nephrolithotomy; The patients will be placed in the supine position with the shoulder and the buttock will be raised by a 3-l bag of water suspending the flank of the affected side. The body contour will be aligned to the edge of the table. The operating table will be adjusted to the jack knife position, with the tip of the lower part of the table will be slightly lowered. The leg of the affected side of the patent will be straightened dorsally flexed and slightly inner rotated, with the knee of the other side will be flexed. The patients will be then immobilized at the chest and the pelvis with two adherent tapes which crossed each other at the abdomen to form a 'V' shape.
Supine percutaneous nephrolithotomy group; This group included 41 patients in supine percutaneous nephrolithotomy.	Procedure: Supine percutaneous nephrolithotomy group; The patient will remain in the supine position, with the side of interest at the edge of the table, with a small cushion placed under the flank to elevate it 15-20°.
Prone percutaneous nephrolithotomy group; This group included 41 patients in prone percutaneous nephrolithotomy.	Procedure: Prone percutaneous nephrolithotomy group; Prone percutaneous nephrolithotomy. The prone position (PRON) technique followed these classic steps: patients will be placed in a lithotomy position and a ureteral catheter will be inserted through a rigid cystoscope to perform a retrograde pyelogram. The ureteral catheter will be fixed to a Foley catheter, and then the patient will be repositioned to the prone position with pads under their shoulders.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stone clearance rate	Comparison of stone clearance rates among different positions (flank suspended supine, supine, and prone) in Ultrasound-Guided Percutaneous Nephrolithotomy (PCNL) for the treatment of renal stones.	3 months postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Operative time	duration of the Ultrasound-Guided Percutaneous Nephrolithotomy (PCNL) procedure among different positions	Intraoperatively
Complication rates	Comparison of postoperative complications (e.g., bleeding, infection, injury) among the different positions.	48 hours Postoperatively
Stone-free rates	Comparison of the percentage of patients achieving complete stone clearance among the different positions.	48 hours Postoperatively

Collaborators and Investigators

• Sponsor: Benha University

Study record dates

Study Major Dates

• Study Start (Actual): January 20, 2018
• Primary Completion (Actual): January 20, 2022
• Study Completion (Actual): January 20, 2022

Study Registration Dates

• First Submitted: May 3, 2023
• First Submitted That Met QC Criteria: May 3, 2023
• First Posted (Estimate): May 11, 2023

Study Record Updates

• Last Update Posted (Estimate): May 11, 2023
• Last Update Submitted That Met QC Criteria: May 3, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Kidney Diseases; Urologic Diseases; Pathological Conditions, Anatomical; Urolithiasis; Urinary Calculi; Calculi; Kidney Calculi; Nephrolithiasis
• Other Study ID Numbers: RC 14-4-2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The study will be available under a reasonable request from the corresponding author
• IPD Sharing Time Frame: One year after the end of the study.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No