Perkütan Nefrolitotomide Supine ve Prone Pozisyonları: Operasyon Etkinliği ve Hasta Konforundaki Rolleri

Year 2025, Volume: 15 Issue: 2, 282 - 287, 22.05.2025

Dursun Baba , İsmail Eyüp Dilek , Emre Ediz , Burak Ayvacık , Yusuf Şenoğlu , Arda Taşkın Taşkıran , Ahmet Yıldırım Balık , Ekrem Başaran , Muhammet Ali Kayıkçı

https://doi.org/10.33631/sabd.1597277

Abstract

Amaç: Bu çalışma, perkütan nefrolitotomi (PCNL) sırasında supine ve prone pozisyonlarının operasyon özellikleri, hasta sonuçları ve postoperatif iyileşme kalitesi üzerindeki etkilerini karşılaştırmayı hedeflemiştir.
Gereç ve Yöntemler: Aralık 2022 ile Ağustos 2024 tarihleri arasında tek bir merkezde renal taş (>2 cm) nedeniyle PCNL uygulanan 78 hastanın retrospektif analizi yapılmıştır. Hastalar, mini-PCNL (mPCNL) supine pozisyonunda tedavi edilen 41 hasta ve standart PCNL (sPCNL) prone pozisyonunda tedavi edilen 37 hasta olmak üzere iki gruba ayrılmıştır. Demografik veriler, operasyon süresi, hastanede yatış süresi, komplikasyon oranları, postoperatif ağrı ve analjezik gereksinimi ile iyileşme kalitesi skorları (QoR) karşılaştırılmıştır. Tedavi etkinliği, ameliyat sonrası 2. ayda taşsızlık (<2 mm rezidü taş) oranı üzerinden değerlendirilmiştir.
Bulgular: Operasyon ve akses süreleri supine grubunda anlamlı olarak daha kısa bulunmuş ve bu grup hastalarında hastanede yatış süresi daha kısa olmuştur. Supine grubunda iyileşme kalitesinde daha belirgin bir iyileşme gözlenmiş, postoperatif ağrı ve analjezik gereksinimleri daha az olmuştur. Ayrıca, supine pozisyonda tedavi edilen hastalarda rezidü taş oranı prone grubuna kıyasla daha düşük bulunmuş ve bu durum tedavi etkinliğinin artmış olduğunu göstermektedir.
Sonuç: mPCNL’de supine pozisyonu, operatif verimlilik, hasta konforu ve postoperatif yaşam kalitesi açısından prone pozisyonuna göre avantajlar sunmaktadır. Bu faydalar göz önünde bulundurulduğunda, PCNL prosedürleri için supine pozisyonu tercih edilebilir bir seçenek olabilir. Daha geniş hasta popülasyonlarında bu bulguların doğrulanması için çok merkezli çalışmalar önerilmektedir.

Keywords

Perkütan Nefrolitotomi, Supine Pozisyon, Prone Pozisyon, Yaşam Kalitesi, İyileşme Kalitesi, Renal Taş, Postoperatif Sonuçlar

Supine and Prone Positions in Percutaneous Nephrolithotomy: Exploring Their Roles in Operative Efficiency and Patient Comfort

Abstract

Aim: This study aimed to compare the effects of supine and prone positions during percutaneous nephrolithotomy (PCNL) on operative characteristics, patient out-comes and postoperative quality of recovery.
Material and Methods: A retrospective analysis was conducted on 78 patients who underwent PCNL for renal stones ≥2 cm at a single center between December 2022 and August 2024. Patients were divided into two groups: 41 treated in the mini-PCNL (mPCNL) supine position and 37 in the standart PCNL (sPCNL) prone position. Demographic data, operative time, hospital stay duration, complication rates, postoperative pain and analgesic requirements and quality of recovery scores (QoR) were compared. Treatment efficacy was assessed based on residual stone presence at 2 months postoperatively, with <2 mm considered stone-free.
Results: Operative and access times were significantly shorter in the supine group and these patients had a reduced hospital stay. Quality of recovery improvement was more pronounced in the supine group with lower postoperative pain and analgesic requirements. Additionally, supine-positioned patients had a lower rate of residual stones compared to the prone group, suggesting enhanced treatment efficacy.
Conclusion: The supine position in mPCNL offers advantages over the prone position in terms of operative efficiency, patient comfort and postoperative quality of recovery. Given these benefits the supine position may be a preferable choice for PCNL procedures. Further multicenter studies are recommended to validate these findings across broader patient populations.

Keywords

Percutaneous nephrolithotomy, supine position, prone position, quality of life, quality of recovery, renal stone, postoperative outcomes

Ethical Statement

The study was con-ducted in accordance with the Declaration of Helsinki and approval was obtained from Düzce University Clinical Research Ethics Committee. (Decision Num-ber:2024/161 Date:19/08/2024)

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