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Supine vs. Prone PCNL for Large Renal Stones: A Randomized Trial in Yemen.

3. juni 2026 oppdatert av: Haitham Mohammed Jowah, Sana'a University

Comparative Evaluation of Early Postoperative Complications, Cost-Effectiveness, and Patient-Centered Outcomes Following Supine and Prone Standard Percutaneous Nephrolithotomy (PCNL): A Randomized Controlled Trial

The goal of this clinical trial is to compare the safety, cost-effectiveness, and patient recovery of two different surgical positions for percutaneous nephrolithotomy (PCNL) in adults aged 18 to 70 years who have kidney stones larger than 2 cm. The main questions it aims to answer are:

  • Does the supine (lying on the back) surgical position result in fewer early postoperative complications than the traditional prone (lying on the stomach) position?
  • Does the supine position reduce the total surgery time, direct hospital costs, and postoperative pain?

Researchers will compare patients assigned to undergo PCNL in the supine position to those assigned to the prone position to see if the supine approach offers a safer, more cost-effective, and more comfortable recovery.

Participants will:

  • Undergo standard PCNL surgery to remove their kidney stones in either the supine or prone position.
  • Have their pain levels, surgery time, and any early surgical complications monitored during their hospital stay.
  • Complete brief questionnaires regarding their overall surgical satisfaction and quality of life at 1 month and 3 months after the procedure.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

140

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Haitham M Jowah, Lecturer
  • Telefonnummer: +967774831058
  • E-post: h.jowah@su.edu.ye

Studer Kontakt Backup

Studiesteder

  • Jemen
      • Sanaa, Jemen, 13078
        • Al-Kuwait University Hospital
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Patients aged 18-70 years.
  • Diagnosis of solitary or multiple renal stones with a cumulative diameter greater than 2 cm, confirmed by imaging (CT KUB).
  • Patients eligible for standard PCNL (24-30 Fr).
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Willingness and ability to provide informed consent.

Exclusion Criteria:

  • Patients with active urinary tract infection (UTI) not responding to antibiotics.
  • Patients with bleeding diathesis or on anticoagulant therapy that cannot be safely discontinued.
  • Patients with anatomical abnormalities of the kidney or urinary tract that preclude standard PCNL.
  • Pregnant women.
  • Patients with severe cardiopulmonary disease where general anesthesia or prolonged surgical positioning is contraindicated.
  • Patients with a history of previous ipsilateral renal surgery.
  • Patients unwilling or unable to comply with follow-up protocols.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Supine PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the supine position.
Fremgangsmåte: Supine Percutaneous Nephrolithotomy (PCNL)
Standard PCNL performed with the patient in the supine position using a standard 24-30 Fr tract.
Aktiv komparator: Prone PCNL
Patients will undergo standard percutaneous nephrolithotomy (24-30 Fr tract size) performed in the conventional prone position.
Fremgangsmåte: Prone Percutaneous Nephrolithotomy (PCNL)
Standard PCNL performed with the patient in the traditional prone position using a standard 24-30 Fr tract.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Incidence and Severity of Early Postoperative Complications
Tidsramme: Up to 30 days post-surgery
Complications will be assessed and classified using the Modified Clavien-Dindo Classification system. The scale ranges from Grade I (minor deviation from normal postoperative course) to Grade V (death of the patient). Lower grades indicate a better outcome.
Up to 30 days post-surgery

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Total Operative Time
Tidsramme: Intraoperative (Day 0)
Total duration of the surgical procedure, measured continuously from the initial skin incision to the final skin closure, recorded in minutes.
Intraoperative (Day 0)
Direct Hospitalization Costs
Tidsramme: From hospital admission to hospital discharge (typically 1 to 7 days)
Total direct medical costs associated with the procedure, calculated as the sum of disposable medical supply costs and hospital stay duration costs. Measured in Yemeni Rials (YER).
From hospital admission to hospital discharge (typically 1 to 7 days)
Postoperative Pain Score
Tidsramme: At 6 hours, 12 hours, and 24 hours post-surgery
Postoperative pain will be evaluated using the Visual Analog Scale. The scale ranges from 0 (no pain) to 10 (worst imaginable pain). Lower scores indicate a better outcome (less postoperative pain).
At 6 hours, 12 hours, and 24 hours post-surgery
Health-Related Quality of Life (HRQoL)
Tidsramme: At 1 month and 3 months post-surgery
Measured using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. The utility index score will be calculated using the Kingdom of Saudi Arabia value set, ranging from -0.683 (worst possible health state) to 1.000 (full health), where higher scores indicate a better outcome (better health-related quality of life).
At 1 month and 3 months post-surgery
Patient Satisfaction Score
Tidsramme: At 30 days post-surgery
Overall patient satisfaction with the surgical experience, anesthetic process, and early recovery will be measured using a 5-point Likert-type satisfaction scale. The scale ranges from 1 (highly dissatisfied) to 5 (highly satisfied), where higher scores indicate a better outcome (greater patient satisfaction).
At 30 days post-surgery

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Sana'a University

Etterforskere

  • Hovedetterforsker: Waleed M Al-Ata, M.B.B.Ch, Al-Kuwait University Hospital
  • Studieleder: Khaled M Al-Kohlany, Associate Professor, Faculty of Medicine and Health Sciences, Sana'a University
  • Studiestol: Abualgaith A Alkholany, MD, Al-Kuwait University Hospital

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. juni 2026

Primær fullføring (Antatt)

1. juni 2027

Studiet fullført (Antatt)

30. juni 2027

Datoer for studieregistrering

Først innsendt

31. mai 2026

Først innsendt som oppfylte QC-kriteriene

31. mai 2026

Først lagt ut (Faktiske)

4. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • PCNL-SANA-2026

Plan for individuelle deltakerdata (IPD)

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NEI

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