Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Braz J Urol (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000500965 |
Resumo: | ABSTRACT Purpose: To evaluate the impact of the patient position on the outcomes of PCNL among patients with complex renal stones. Material and Methods: From July 2011 to July 2014, we collected prospective data of consecutive patients who underwent PCNL. We included all patients with complex stones (Guy's Stone Score 3 or 4 (GSS) based on a CT scan) and divided them based on the position used during PCNL (prone or supine). The variables analyzed were gender, age, body mass index, ASA score, stone diameter, GSS, number of punctures, calyx puncture site, intercostal access and patient positioning. Complications were graded according to the modified-Clavien Classification. Success was considered if fragments ≤ 4mm were observed on the first postoperative day CT scan. Results: We analyzed 240 (46.4%) of 517 PCNL performed during the study period that were classified as GGS 3-4. Regarding patient positions, 21.2% were prone and 79.8% were supine. Both groups were comparable, although intercostal access was more common in prone cases (25.5% vs 10.5%; p=0.01). The success rates, complications, blood transfusions and surgical times were similar for both groups; however, there were significantly more visceral injuries (10.3% vs 2.6%; p=0.046) and sepsis (7.8% vs 2.1%; p=0.042) in prone cases. Conclusion: Supine or prone position were equally suitable for PCNL with complex stones and did not impact the success rates. However, supine position was associated with fewer sepsis cases and visceral injuries. |
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International Braz J Urol (Online) |
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Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stonesKidney CalculiNephrolithotomyPercutaneousSupine PositionProne PositionABSTRACT Purpose: To evaluate the impact of the patient position on the outcomes of PCNL among patients with complex renal stones. Material and Methods: From July 2011 to July 2014, we collected prospective data of consecutive patients who underwent PCNL. We included all patients with complex stones (Guy's Stone Score 3 or 4 (GSS) based on a CT scan) and divided them based on the position used during PCNL (prone or supine). The variables analyzed were gender, age, body mass index, ASA score, stone diameter, GSS, number of punctures, calyx puncture site, intercostal access and patient positioning. Complications were graded according to the modified-Clavien Classification. Success was considered if fragments ≤ 4mm were observed on the first postoperative day CT scan. Results: We analyzed 240 (46.4%) of 517 PCNL performed during the study period that were classified as GGS 3-4. Regarding patient positions, 21.2% were prone and 79.8% were supine. Both groups were comparable, although intercostal access was more common in prone cases (25.5% vs 10.5%; p=0.01). The success rates, complications, blood transfusions and surgical times were similar for both groups; however, there were significantly more visceral injuries (10.3% vs 2.6%; p=0.046) and sepsis (7.8% vs 2.1%; p=0.042) in prone cases. Conclusion: Supine or prone position were equally suitable for PCNL with complex stones and did not impact the success rates. However, supine position was associated with fewer sepsis cases and visceral injuries.Sociedade Brasileira de Urologia2018-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000500965International braz j urol v.44 n.5 2018reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/s1677-5538.ibju.2018.0163info:eu-repo/semantics/openAccessVicentini,Fabio CarvalhoPerrella,RodrigoSouza,Vinicius M. G.Hisano,MarceloMurta,Claudio BovolentaClaro,Joaquim Francisco de Almeidaeng2018-10-24T00:00:00Zoai:scielo:S1677-55382018000500965Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2018-10-24T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false |
dc.title.none.fl_str_mv |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones |
title |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones |
spellingShingle |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones Vicentini,Fabio Carvalho Kidney Calculi Nephrolithotomy Percutaneous Supine Position Prone Position |
title_short |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones |
title_full |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones |
title_fullStr |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones |
title_full_unstemmed |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones |
title_sort |
Impact of patient position on the outcomes of percutaneous neprolithotomy for complex kidney stones |
author |
Vicentini,Fabio Carvalho |
author_facet |
Vicentini,Fabio Carvalho Perrella,Rodrigo Souza,Vinicius M. G. Hisano,Marcelo Murta,Claudio Bovolenta Claro,Joaquim Francisco de Almeida |
author_role |
author |
author2 |
Perrella,Rodrigo Souza,Vinicius M. G. Hisano,Marcelo Murta,Claudio Bovolenta Claro,Joaquim Francisco de Almeida |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Vicentini,Fabio Carvalho Perrella,Rodrigo Souza,Vinicius M. G. Hisano,Marcelo Murta,Claudio Bovolenta Claro,Joaquim Francisco de Almeida |
dc.subject.por.fl_str_mv |
Kidney Calculi Nephrolithotomy Percutaneous Supine Position Prone Position |
topic |
Kidney Calculi Nephrolithotomy Percutaneous Supine Position Prone Position |
description |
ABSTRACT Purpose: To evaluate the impact of the patient position on the outcomes of PCNL among patients with complex renal stones. Material and Methods: From July 2011 to July 2014, we collected prospective data of consecutive patients who underwent PCNL. We included all patients with complex stones (Guy's Stone Score 3 or 4 (GSS) based on a CT scan) and divided them based on the position used during PCNL (prone or supine). The variables analyzed were gender, age, body mass index, ASA score, stone diameter, GSS, number of punctures, calyx puncture site, intercostal access and patient positioning. Complications were graded according to the modified-Clavien Classification. Success was considered if fragments ≤ 4mm were observed on the first postoperative day CT scan. Results: We analyzed 240 (46.4%) of 517 PCNL performed during the study period that were classified as GGS 3-4. Regarding patient positions, 21.2% were prone and 79.8% were supine. Both groups were comparable, although intercostal access was more common in prone cases (25.5% vs 10.5%; p=0.01). The success rates, complications, blood transfusions and surgical times were similar for both groups; however, there were significantly more visceral injuries (10.3% vs 2.6%; p=0.046) and sepsis (7.8% vs 2.1%; p=0.042) in prone cases. Conclusion: Supine or prone position were equally suitable for PCNL with complex stones and did not impact the success rates. However, supine position was associated with fewer sepsis cases and visceral injuries. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000500965 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000500965 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1677-5538.ibju.2018.0163 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
dc.source.none.fl_str_mv |
International braz j urol v.44 n.5 2018 reponame:International Braz J Urol (Online) instname:Sociedade Brasileira de Urologia (SBU) instacron:SBU |
instname_str |
Sociedade Brasileira de Urologia (SBU) |
instacron_str |
SBU |
institution |
SBU |
reponame_str |
International Braz J Urol (Online) |
collection |
International Braz J Urol (Online) |
repository.name.fl_str_mv |
International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU) |
repository.mail.fl_str_mv |
||brazjurol@brazjurol.com.br |
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1750318076335751168 |