PCNL in Supine Position for Renal Complicated Calculi

Objective To evaluate the safety and efficacy of PCNL in supine anterolateral position for renal complicated calculi. Methods 32 cases of renal complicated calculi were treated including 18 men and 14 females with mean age 43.5 years. There were staghorn calculi 12 cas-es,large and multiple calculi 20 cases. The stone size 2.7~4.1cm.20 cases were complicafed with varied hydronephrosis. The supine position was obtained with towels under shoulder and gluteus to elevate the flank 35°to 45°with the flank stretching,ultrasound-guided puncture toward the middle calices was done. Dilating the access to 18~20F,a nephrolithostripy was done to fragment the calculi. A 16F nephrostomy and 4F pigtail catheter was inserted after procedure. Results 32 cases underwent 44 PCNLs. 12 cases(37.5%)had needed two sessions. The mean operation time was(103±18)min. No circulatory and ventilatory problems related to the position occurred. 9 cases(28.1%)needed blood transfusion because of obviously bleeding during or postoperation. No visceral organ and pleural injury happened. Overall stone-free rate was 86%. Conclusion PCNL in supine position for renal complicated calculi is safe,effective and easy-doing and is worth applying in clinic.