Supin Perkütan Nefrolitotomi-Eski Köye Yeni Adet

Günümüzde büyük ve kompleks böbrek taşlarının tedavisinde önerilen modalite olan perkütan nefrolitotomi (PNL), yıllar içerisinde hem taşsızlık oranlarını arttırmak hem de komplikasyonları minimize etmek için çeşitli modifikasyonlara uğradı. Bu değişimlerden biri, diğer birçok başka avantajının yanında ergonomik bir biçimde endoskopik kombine intrarenal cerrahi yapılabilmesine de olanak sağlaması açısından supin pozisyona geçiş oldu. Her yeni cerrahi teknik gibi supin PNL de başlangıçta cerrahlar tarafından süregelen alışkanlıklarının dışına çıkılması sebebiyle mesafeli karşılansa da geçiş yapan endoürologların üstünlükleri bilimsel olarak ortaya koyması ile son yıllarda giderek artan sayıda taraftar toplamaya başladı. Biz bu makalemizde, supin PNL’nin pron pozisyona kıyasla sahip olduğu avantajları, yaşanabilecek pozisyona bağlı problemlerin çözüm yollarını ve supin pozisyon hakkında doğru bilindiği sanılan yanlışların gerçeklerini anlatmaya çalıştık.

Supine Percutaneous Nephrolithotomy - New Tricks to Old Dogs

Percutaneous nephrolithotomy (PNL), the recommended modality in the treatment of large and complex kidneystones, has undergone various modifications over the years in order to increase stone-free rates and to minimizecomplications. One of these modifications was the transition to the supine position, which, among many otheradvantages, allowed to perform endoscopic combined intrarenal surgery ergonomically. As with all new surgicaltechniques, supine PNL had been questionable for the surgeons at the beginning for the reason of acting out ofongoing surgical habits. However, due to that the endourologists who had shifted to this technique have provenits superiorities scientifically, supine PNL has become much more popular during recent times. In this article, weaimed to discuss the advantages of supine PNL compared to prone position, to present the solutions for the possibleproblems related to position, and to clarify some certain misunderstandings about the supine position.

___

  • 1. Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc. 1955; 157:891- 894.
  • 2. Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol. 1976; 10:257-259.
  • 3. Ibarluzea G, Scoffone CM, Cracco CM, Poggio M, Porpiglia F, Terrone C, et al. Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access. BJU Int. 2007;100(1):233-6.
  • 4. Armitage J, Irving S, Burgess N. Percutaneous Nephrolithotomy in the United Kingdom: Results of a Prospective Data Registry. Eur Urol. 2012; 61(6): p. 1188‐93.
  • 5. De la Rosette J, Assimos D, Desai M, et al. The Clinical Research Office of the Endourological Society percutaneous nephrolithotomy global study. J Endouro. 2011; 25(1): p. 11‐17.
  • 6. Valdivia-Uría JG, Valle Gerhold J, López López JA, et al. Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position. J Urol. 1998; 160:1975- 1978.
  • 7. Falahatkar S, Moghaddam AA, Salehi M, et al. Complete supine percutaneous nephrolithotripsy comparison with the prone standard technique. J Endourol 2008;22:2513-7.
  • 8. Kerbl K, Clayman RV, Chandhoke PS, et al. Percutaneous stone removal with the patient in a flank position. J Urol 1994;151:686-8.
  • 9. Papatsoris AG, Zaman F, Panah A, et al. Simultaneous anterograde and retrograde endourologic access: "the Barts technique". J Endourol 2008;22:2665-6.
  • 10. Bach C, Goyal A, Kumar P, et al. The Barts 'flank-free' modified supine position for percutaneous nephrolithotomy. Urol Int 2012;89:365-8.
  • 11. Proietti S, Rodriguez-Socarras ME, Eisner B, et al. Supine percutaneous nephrolithotomy: tips and tricks. Transl Androl Urol. 2019;8(Suppl 4):381-8.
  • 12. Giusti G, De Lisa A. PCNL in the prone position VS PCNL in the modified supine Double-S position: is there a better position? A prospective randomized trial. Urolithiasis. 2018.
  • 13. Edgcombe H, Carter K, Yarrow S. Anaesthesia in the prone position. Br J Anaesth. 2008;100(2):165-83.
  • 14. Agah M, Ghasemi M, Roodneshin F, Radpay B, Moradian S. Prone position in percutaneous nephrolithotomy and postoperative visual loss. Urol J. 2011;8(3):191-6.
  • 15. Roth S, Thisted RA, Erickson JP, Black S, Schreider BD. Eye injuries after nonocular surgery. A study of 60,965 anesthetics from 1988 to 1992. Anesthesiology. 1996;85(5):1020-7.
  • 16. Roth S, Tung A, Ksiazek S. Visual loss in a prone-positioned spine surgery patient with the head on a foam headrest and goggles covering the eyes: an old complication with a new mechanism. Anesth Analg. 2007;104(5):1185-7, tables of contents.
  • 17. Manohar T, Jain P, Desai M. Supine percutaneous nephrolithotomy: Effective approach to high-risk and morbidly obese patients. J Endourol 2007;21:44-9.
  • 18. Khoshrang H, Falahatkar S, Ilat S, et al. Comparative study of hemodynamics electrolyte and metabolic changes during prone and complete supine percutaneous nephrolithotomy. Nephrourol Mon 2012;4:622-8.
  • 19. Shoma AM, Eraky I, El-Kenawy MR, El-Kappany HA. Percutaneous nephrolithotomy in the supine position: technical aspects and functional outcome compared with the prone technique. Urology. 2002;60(3):388–92.
  • 20. St-Laurent MP, Doizi S, Rosec M, Terrasa JB, Villa L, Traxer O, et al. Radiation exposure in prone vs. modified supine position during PCNL: Results with an anthropomorphic model. Can Urol Assoc J. 2019;13(8):246-9.
  • 21. Koo BC, Burtt G, Burgess NA. Percutaneous stone surgery in the obese: outcome stratified according to body mass index. BJU Int. 2004;93(9):1296–1299.
  • 22. Keheila M, Leavitt D, Galli R, et al. Percutaneous nephrolithotomy in super obese patients (body mass index ≥50 kg/m2): overcoming the challenges. BJU Int. 2016;117(2):300–306.
  • 23. Zhou X, Sun X, Chen X, et al. Effect of obesity on outcomes of percutaneous nephrolithotomy in renal stone management: a systematic review and meta-analysis. Urol Int. 2017;98(4):382–390.
  • 24. Mazzucchi E, Vicentini FC, Marchini GS, Danilovic A, Brito AH, Srougi M. Percutaneous nephrolithotomy in obese patients: comparison between the prone and total supine position. J Endourol. 2012;26(11):1437-42.
  • 25. Li J, Gao L, Li Q, Zhang Y, Jiang Q. Supine versus prone position for percutaneous nephrolithotripsy: A meta-analysis of randomized controlled trials. Int J Surg. 2019;66:62-71.
  • 26. Yuan D, Liu Y, Rao H, et al. Supine Versus Prone Position in Percutaneous Nephrolithotomy for Kidney Calculi: A Meta-Analysis. J Endourol. 2016;30(7):754–763.
  • 27. Zhang X, Xia L, Xu T, Wang X, Zhong S, Shen Z. Is the supine position superior to the prone position for percutaneous nephrolithotomy (PCNL)? Urolithiasis. 2014;42(1):87–93.
  • 28. Al-Dessoukey AA, Moussa AS, Abdelbary AM, Zayed A, Abdallah R, Elderwy AA, et al. Percutaneous nephrolithotomy in the oblique supine lithotomy position and prone position: a comparative study. J Endourol. 2014;28(9):1058-63.
  • 29. Scoffone CM, Cracco CM, Cossu M, et al. Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: A new standard for percutaneous nephrolithotomy? Eur Urol 2008;54:1393–1403.
  • 30. Scoffone CM, Cracco CM. Invited review: the tale of ECIRS (Endoscopic Combined IntraRenal Surgery) in the Galdakao-modified supine Valdivia position. Urolithiasis. 2018;46(1):115-23.
  • 31. Lehman T, Bagley DH. Reverse lithotomy: Modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women. Urology 1988;32:529–531.
  • 32. Grasso M, Nord R, Bagley DH. Prone split leg and flank roll positioning: Simultaneous antegrade and retrograde access to the upper urinary tract. J Endourol 1993;7:307–310.
  • 33. Hamamoto S, Yasui T, Okada A, Koiwa S, Taguchi K, Itoh Y, et al. Efficacy of endoscopic combined intrarenal surgery in the prone split-leg position for staghorn calculi. J Endourol. 2015;29(1):19-24.
  • 34. Curry D, Srinivasan R, Kucheria R, Goyal A, Allen D, Goode A, et al. Supine Percutaneous Nephrolithotomy in the Galdako-Modified Valdivia Position: A High-Volume Single Center Experience. J Endourol. 2017;31(10):1001-6.
  • 35. Falahatkar S, Mokhtari G, Amin A, Kazemnezhad E, Esmaeili S, Rastjou Herfeh N, et al. Comparison of the outcomes of complete supine percutaneous nephrolithotomy in patients with radiopaque and radiolucent kidney stones. Turk J Urol 2017; 43(4): 490-6.
  • 36. Sofer M, Giusti G, Proietti S, et al. Upper calyx approachability through a lower calyx access: comparison between prone and supine PCNL and assessment of anatomical factors that may influence it using three dimensional CT reconstructions. J Urol 2015. doi: 10.1016/j.juro.2015.07.101.
  • 37. Guglielmetti GB, Danilovic A, Torricelli FC, Coelho RF, Mazzucchi E, Srougi M. Predicting calyceal access for percutaneous nephrolithotomy with computed tomography multiplanar reconstruction. Clinics. 2013;68(6):892-895.
  • 38. El-Nahas AR, Shokeir AA, El-Assmy AM, et al. Colonic perforation during percutaneous nephrolithotomy: study of risk factors. Urology. 2006;67:937-941.
  • 39. Hopper KD, Sherman JL, Luethke JM, et al. The retro-renal colon in the supine and prone patient. Radiol. 1987;162:443-446.
  • 40. Tuttle DN, Yeh BM, Meng MV, Breiman RS, Stoller ML, Coakley FV. Risk of injury to adjacent organs with lower-pole fluoroscopically guided percutaneous nephrostomy: evaluation with prone, supine, and multiplanar reformatted CT. J Vasc Interv Radiol. 2005;16(11):1489-92.
  • 41. Desoky EAE, Eliwa AM, Fawzi AM, Sakr AM, Maarouf AM, Shahin AS, et al. Radiologic Relation of the Colon to the Trajectory of Percutaneous Nephrolithotomy Access in Prone Versus Flank-free Modified Supine Position: A Prospective Study of Intra and Interindividual Influencing Factors. Urology. 2018;115:71-5.
  • 42. Vallancien G, Capdeville R, Veillon B, Charton M, Brisset JM. Colonic perforation during percutaneous nephrolithotomy. J Urol. 1985;134:1185-1187,
  • 43. Maillet PJ, Dulac JP, Barth X, Pelle-Francoz D, Bobin JY. Colonic perforations during interventional urinary radiology. J Radiol.1986;67:225-229.
  • 44. Rodrigues Netto N, Lemos GC, Fiuza JL. Colon perforation following percutaneous nephrolithotomy. J Urol. 1988;32:223-224.
  • 45. Prassopoulos P, Gourtsoyiannis N, Cavouras D, et al. A study of the variation of colonic positioning in the pararenal space as shown by computed tomography. Eur J Radiol. 1990;10:44-47.
  • 46. Gokce MI, Ibis A, Sanci A, Akinci A, Bagci U, Agaoglu EA, et al. Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones. Urolithiasis. 2017;45(6):603-8.
  • 47. Otano N, Jairath A, Mishra S, Ganpule A, Sabnis R, Desai M. Percutaneous nephrolithotomy in pelvic kidneys: is the ultrasound-guided puncture safe? Urology. 2015;85(1):55-8.
  • 48. Gamal W, Moursy E, Hussein M, Mmdouh A, Hammady A, Aldahshoury M, et al. Supine pediatric percutaneous nephrolithotomy (PCNL). J Pediatr Urol 2015; 11:78.1-5.
  • 49. Nerli RB, Mungarwadi A, Ghagane SC, Dixit NS, Hiremath MB. Supine percutaneous nephrolithotomy in children. J Sci Soc 2018;45:63-6.
  • 50. Tanriverdi O, Boylu U, Kendirci M, Kadihasanoglu M, Horasanli K, Miroglu C. The learning curve in the training of percutaneous nephrolithotomy. Eur Urol 2007;52:206-11.
  • 51. Allen D, O'Brien T, Tiptaft R, Glass J. Defining the learning curve for percutaneous nephrolithotomy. J Endourol 2005;19:279-82.
  • 52. Jang WS, Choi KH, Yang SC, Han WK. The Learning Curve for Flank Percutaneous Nephrolithotomy for Kidney Calculi: A Single Surgeon's Experience. Korean J Urol. 2011;52(4):284-8.
  • 53. Gulpinar B, Akinci A, Suer E, Sanci A, Babayigit M, Beduk Y, et al. Prospective evaluation of kidney displacement during supine mini-percutaneous nephrolithotomy: Incidence, significance, and analysis of predictive factors. Can Urol Assoc J. 2018;12(11):E475-e9.
  • 54. Assimos D, Krambeck A, Miller NL. Surgical Management of Stones: American Urological Association/ Endourological Society Guideline, PART II. J Urol 2016;196:1161-9.
  • 55. Cormio L, Annese P, Corvasce T, et al. Percutaneous nephrostomy in supine position. Urology 2007; 69:377 – 380.
Endoüroloji Bülteni-Cover
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2020
  • Yayıncı: ENDOÜROLOJİ DERNEĞİ