Prone versus Barts “flank-free” modified supine percutaneous nephrolithotomy: a match-pair analysis

Turk J Med Sci. 2021 Jun 28;51(3):1373-1379. doi: 10.3906/sag-2011-21.

Abstract

Background/aim: In this study, we aimed to compare the results of prone and Barts “flank-free” modified supine percutaneous nephrolithotomy (PCNL) operations in our clinic.

Materials and methods: The data from patients that underwent Barts “flank-free” modified supine PCNL (BS-PCNL) (n = 52) between June 2018 and July 2020 and prone PCNL (P-PCNL) (n = 286) between April 2014 and June 2018 were retrospectively evaluated. Of those 286 patients, 104 patients whose sex, age, body mass index, American Society of Anesthesiology score, stone localization, stone size, and hydronephrosis matched the BS-PCNL group in a 1:2 ratio were included in the study. The groups were compared in terms of intraoperative outcome, complication rates, and stone-free rates.

Results: The mean age of all patients (58 females, 98 males) included in the study was 41.8 ± 15.2 years, and the mean body mass index (BMI) was 24.7 ± 2.9 kg/m2. The mean operation time was significantly shorter in the BS-PCNL group than in the P-PCNL group (80.2 ± 15.1 min vs. 92.4 ± 22.7 min and p = 0.01). There was no significant difference between the two groups in terms of fluoroscopy time, intraoperative complications, postoperative complications, and stone-free rates.

Conclusion: Our study shows that BS-PCNL is an effective and safe method that significantly reduces the operation time and should be considered as one of the primary treatment options for patients scheduled for PCNL.

Keywords: Barts flank-free modified supine position; kidney stone; prone; Percutaneous nephrolithotomy; Barts “flank-free” modified supine position; stone-free rate.