Objective:

To evaluate the results of percutaneous nephrolithotomy (PNL) in two positions (prone and supine) in a tertiary reference center.

Method:

Cross-sectional, analytical study of patients undergoing percutaneous nephrolithotomy between January 2017 and October 2021, in Cali, Colombia. Variables analyzed: stone size (measured in millimeters), age, American Society of Anesthesiologists (ASA score) classification, stone-free rate, hospital stay, need for transfusion, intervention position, operative time and Clavien-Dindo system postoperative complications. The primary outcome was stone-free rate and the secondary outcomes were length of hospital stay, Clavien-Dindo complications, and operative time.

Results:

One hundred-fifty were operated on prone and 55 supine. For prone position stone size had an average of 28.1 ± 10.1 mm, by supine position 32.4 ± 12.5 mm. Stone-free rate for prone 63.3% and supine 70.9% (p = 0.31). A length of hospital stay in prone position was 3.4 ± 2.7 days and in the supine position 5.01 ± 5.6 days (p = 0.046). Clavien-Dindo complications ≥ 3 in prone of 2.67% vs. 0% in supine (p = 0.0063). Surgical time increased hospital stay (odds ratio [OR]: 1.48; 95% CI: 1.07-2.06). The main predictors of longer surgical time were the position of the approach (OR: 4.55; 95% CI: 1.75-11.7) and the size of the stone (OR: 1.49; 95% CI: 1.09-2.05).

Conclusion:

The NLP performance position does not modify the stone-free rate. There was a longer hospital stay in the supine position and a longer operative time without an increase in Clavien-Dindo complications. Surgical time was associated with longer hospital stay and approach position and stone size with longer surgical time.

        · resumo em Espanhol     · texto em Espanhol     · Espanhol ( pdf )