Download PDF
CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2018; 27(03): 223-232
DOI: 10.1055/s-0038-1639584
Review Article | Artículo de Revisión
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Historia y actualidad de las diferencias entre la posición prono y supino en nefrolitotomia percutánea

History and Present of the Differences between the Prone and Supine Position in Percutaneous Nephrolithotomy
Néstor D. Rivillas-Miranda
1   Médico, Residente de Urología, Facultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, Colombia
,
Catalina González Yepes
1   Médico, Residente de Urología, Facultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, Colombia
,
Jenny García Valencia
2   Médica, Doctora en Epidemiología, Grupo Académico de Epidemiología (GRAEPIC), Facultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, Colombia
,
Manuel Cabrales Hessen
3   Médico Urólogo, IPS Universitaria Clínica Leon XIII y Docente del Posgrado de Urología, Facultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, Colombia
› Author Affiliations
Further Information

Publication History

29 September 2016

19 July 2017

Publication Date:
18 May 2018 (online)

   Permissions and Reprints

Resumen

La posición de decúbito prono se ha considerado la principal para el acceso percutáneo al riñón durante los últimos 25 años; mientras que la posición supina de Valdivia ha comenzado recientemente a ganar aceptación, aunque fue descrita originalmente en la década de 1980. Incluso, más recientemente, la posición supina Valdivia Galdakao - modificada fue descrita. Sin embargo, no hay consenso sobre cuál es la mejor posición para la nefrolitotomía percutánea y la elección se basa actualmente en la preferencia del cirujano. Este artículo tiene por objetivo revisar la evidencia sobre ambas técnicas quirúrgicas y dar elementos al lector para tomar decisiones. No hay diferencias en la tasa de éxito, entendida como tasa libre de cálculo entre las posiciones prono y supino. En prono hay mayor riesgo de sangrado y necesidad de transfusiones, así como mayor tiempo quirúrgico. La posición supina se ha descrito como más segura en pacientes con obesidad, enfermedades pulmonares restrictivas y alteraciones anatómicas óseas y de la vía urinaria.

Abstract

The prone position has been considered the principal for percutaneous access to the kidney during the past 25 years; while the Valdiviàs supine position has recently begun to gain acceptance, although it was originally described in the 1980. Even more recently, the position supine of Valdivia - Galdakao - was described. However, there is no consensus on which is the best position for percutaneous nephrolithotomy and the choice is currently based on the surgeon's preference. This article aims to review the evidence on both surgical techniques and elements give the reader to make decisions. There is no difference in the success rate, defined as free rate calculation between the prone and supine positions. Prone increased risk of bleeding and need for transfusions and longer surgical time. The supine position has been described as safer in patients with obesity, restrictive lung disease, anatomical bone abnormalities and urinary tract malformations.

Palabras Claves

riñón - cálculo renal - nefrolitotomía percutánea - nefrostomía percutánea - Imagen postoperatoria - litotripsia intracorporea - ureterolitotomía endoscópica

Keywords

kidney - kidney calculi - percutaneous nephrolithotomy - percutaneous nephrostomy - post-operative imaging - intracorporeal lithotripsy
 

  • Referencias

  • 1 Falahatkar S, Mohiti M, Atefeh S, Ahmad E, Pourhadi H, Allahkhah A. Complete supine percutaneous nephrolithotomy (csPCNL) in patients with and without a history of stone surgery: safety and e V ectiveness of csPCNL. Urol Res 2011; 39 (04) 295-301
    CrossrefPubMedGoogle Scholar
  • 2 Vellinga SVR. Global PCNL study URS study Greenlight Laser study Renal Mass study. 2009: 1089-1092 DOI: 10.1089=end.2009.1517
    PubMedGoogle Scholar
  • 3 Tugcu V, Su FE, Kalfazade N, Sahin S, Ozbay B, Tasci AI. Percutaneous nephrolithotomy (PCNL) in patients with previous open stone surgery. Int Urol Nephrol 2008; 40 (04) 881-884 . Doi: 10.1007/s11255-008-9376-1
    CrossrefPubMedGoogle Scholar
  • 4 Türk C, Petrik A, Sarica K. , et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol 2015; 69 (03) 475-482 . Doi: 10.1159/000049803
    PubMedGoogle Scholar
  • 5 Jean de la Rosette MD, Dean Assimos MD, Mahesh Desai MD. , et al. Group on behalf of the CPS. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Indications, Complications, and Outcomes in 5803 Patients. J Endourol 2009; 23 (07) 1089-1091
    CrossrefPubMedGoogle Scholar
  • 6 Bernardo NO. Percutâneo Renal Access Under Fluoroscopic Control. In Smith AD, Badlani GH, Preminger GM, Kavoussi LR. (eds). Smith's Textbook of Endourology. pp 2012: 180-188 doi: 10.1002/9781444345148.ch13
    CrossrefGoogle Scholar
  • 7 Steele D, Marshall V. Percutaneous nephrolithotomy in the supine position: a neglected approach?. J Endourol 2007; 21 (12) 1433-1437
    CrossrefPubMedGoogle Scholar
  • 8 Karami H, Mohammadi R, Lotfi B. A study on comparative outcomes of percutaneous nephrolithotomy in prone, supine, and flank positions. World J Urol 2013; 31 (05) 1225-1230
    CrossrefPubMedGoogle Scholar
  • 9 Ibarluzea González G, Gamarra Quintanilla M, Gallego Sánchez JA, Pereira Arias JG, Camargo Ibargaray I, Bernuy Malfaz C. Litotricia renal percutánea. Evolución, indicaciones y metodología actual en nuestra Unidad de Litotricia. Arch Esp Urol 2001; 54 (09) 951-969
    PubMedGoogle Scholar
  • 10 Cormio L, Preminger G, Saussine C. , et al. Nephrostomy in percutaneous nephrolithotomy (PCNL): does nephrostomy tube size matter? Results from the Global PCNL Study from the Clinical Research Office Endourology Society. World J Urol 2013; 31 (06) 1563-1568
    CrossrefPubMedGoogle Scholar
  • 11 Antonelli JA, Pearle MS. Advances in percutaneous nephrolithotomy. Urol Clin North Am 2013; 40 (01) 99-113
    CrossrefPubMedGoogle Scholar
  • 12 Ghani KR, Andonian S, Bultitude M. , et al. Percutaneous Nephrolithotomy: Update, Trends, and Future Directions. Eur Urol 2016; 70 (02) 382-396
    CrossrefPubMedGoogle Scholar
  • 13 Tan YK, Cha DY, Gupta M. Management of stones in abnormal situations. Urol Clin North Am 2013; 40 (01) 79-97
    CrossrefPubMedGoogle Scholar
  • 14 Acar C, Cal C. Impact of Residual Fragments following Endourological Treatments in Renal Stones. Adv Urol 2012; 2012: 813523
    PubMedGoogle Scholar
  • 15 Osman Y, Harraz AM, El-Nahas AR. , et al. Clinically insignificant residual fragments: an acceptable term in the computed tomography era?. Urology 2013; 81 (04) 723-726
    CrossrefPubMedGoogle Scholar
  • 16 Gokce MI, Ozden E, Suer E, Gulpinar B, Gulpınar O, Tangal S. Comparison of imaging modalities for detection of residual fragments and prediction of stone related events following percutaneous nephrolitotomy. Int Braz J Urol 2015; 41 (01) 86-90
    CrossrefPubMedGoogle Scholar
  • 17 Raman JD, Bagrodia A, Gupta A. , et al. Natural history of residual fragments following percutaneous nephrostolithotomy. J Urol 2009; 181 (03) 1163-1168
    CrossrefPubMedGoogle Scholar
  • 18 Rebuck DA, Macejko A, Bhalani V, Ramos P, Nadler RB. The natural history of renal stone fragments following ureteroscopy. Urology 2011; 77 (03) 564-568
    CrossrefPubMedGoogle Scholar
  • 19 Macejko A, Okotie OT, Zhao LC, Liu J, Perry K, Nadler RB. Computed tomography-determined stone-free rates for ureteroscopy of upper-tract stones. J Endourol 2009; 23 (03) 379-382
    CrossrefPubMedGoogle Scholar
  • 20 Paonessa J, Lingeman JE. Extracorporeal shock wave lithotripsy: generators and treatment techniques, Chap 18. In: Grasso M, Golfarb DS. Urinary stones: medical and surgical management. Wiley-Blackwell: Oxford; 2014: 216-226 doi: 10.1002/9781118405390.ch18
    CrossrefGoogle Scholar
  • 21 De S, Autorino R, Kim FJ. , et al. Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis. Eur Urol 2015; 67 (01) 125-137
    CrossrefPubMedGoogle Scholar
  • 22 Donaldson JF, Lardas M, Scrimgeour D. , et al. Systematic review and meta-analysis of the clinical effectiveness of shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy for lower-pole renal stones. Eur Urol 2015; 67 (04) 612-616 . Doi: 10.1016/j.eururo.2014.09.054
    CrossrefPubMedGoogle Scholar
  • 23 Okhunov Z, Friedlander JI, George AK. , et al. S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology 2013; 81 (06) 1154-1159 . Doi: 10.1016/j.urology.2012.10.083
    CrossrefPubMedGoogle Scholar
  • 24 Labadie K, Okhunov Z, Akhavein A. , et al. Evaluation and comparison of urolithiasis scoring systems used in percutaneous kidney stone surgery. J Urol 2015; 193 (01) 154-159 . Doi: 10.1016/j.juro.2014.07.104
    CrossrefPubMedGoogle Scholar
  • 25 Smith A, Averch TD, Shahrour K. , et al; CROES PCNL Study Group. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol 2013; 190 (01) 149-156 . Doi: 10.1016/j.juro.2013.01.047
    CrossrefPubMedGoogle Scholar
  • 26 Kanao K, Nakashima J, Nakagawa K. , et al. Preoperative nomograms for predicting stone-free rate after extracorporeal shock wave lithotripsy. J Urol 2006; 176 (4 Pt 1): 1453-1456
    CrossrefPubMedGoogle Scholar
  • 27 Noureldin YA, Elkoushy MA. Which is better? Guy ' s versus S. T. O. N. E. nephrolithometry scoring systems in predicting stone - free status post - percutaneous nephrolithotomy. World J Urol 2015; 1821-1825 . Doi: 10.1007/s00345-015-1508-5
    PubMedGoogle Scholar
  • 28 Keoghane SR, Cetti RJ, Rogers AE, Walmsley BH. Blood transfusion, embolisation and nephrectomy after percutaneous nephrolithotomy (PCNL). BJU Int 2013; 111 (04) 628-632
    CrossrefPubMedGoogle Scholar
  • 29 Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 1992; 111 (05) 518-526
    Google Scholar
  • 30 Torrecilla C, Vicéns-Morton AJ, Meza IA. , et al. Complications of percutaneous nephrolithotomy in the prone position according with modified Clavien-Dindo grading system. Actas Urol Esp 2015; 39 (03) 169-174
    CrossrefPubMedGoogle Scholar
  • 31 Dindo D, Demartines N, Clavien P-A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240 (02) 205-213 . Doi: 10.1097/01.sla.0000133083.54934.ae
    CrossrefPubMedGoogle Scholar
  • 32 Clavien PA, Barkun J, de Oliveira ML. , et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009; 250 (02) 187-196 . Doi: 10.1097/SLA.0b013e3181b13ca2
    CrossrefPubMedGoogle Scholar
  • 33 De JJMCH, Opondo D, Daels FPJ. , et al. Platinum Priority – Endo-urology Categorisation of Complications and Validation of the Clavien Score for Percutaneous Nephrolithotomy. Eur Urologoy 2012; 62: 246-255
    PubMedGoogle Scholar
  • 34 de la Rosette J, Assimos D, Desai M. , et al; CROES PCNL Study Group. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol 2011; 25 (01) 11-17 . Doi: 10.1089/end.2010.0424
    CrossrefPubMedGoogle Scholar
  • 35 Labate G, Modi P, Timoney A. , et al. The percutaneous nephrolithotomy global study: classification of complications. J Endourol 2011; 25 (08) 1275-1280 . Doi: 10.1089/end.2011.0067
    CrossrefPubMedGoogle Scholar
  • 36 Lee JK, Kim BS, Park YK. Predictive factors for bleeding during percutaneous nephrolithotomy. Korean J Urol 2013; 54 (07) 448-453
    CrossrefPubMedGoogle Scholar
  • 37 Kumar S, Devana SK, Singh SK, Mittal A. Complete obliteration of post percutaneous nephrolithotomy (PCNL) pseudoaneurysm following administration of tranexamic acid. Urolithiasis 2013; 41 (03) 273-275
    CrossrefPubMedGoogle Scholar
  • 38 Yu DS. Gelatin packing of intracortical tract after percutaneous nephrostomy lithotripsy for decreasing bleeding and urine leakage. J Chin Med Assoc 2006; 69 (04) 162-165 . Doi: 10.1016/S1726-4901(09)70198-4
    CrossrefPubMedGoogle Scholar
  • 39 Oguz U, Resorlu B, Bayindir M, Sahin T, Bozkurt OF, Unsal A. Emergent intervention criterias for controlling sever bleeding after percutaneous nephrolithotomy. ISRN Urol 2013; 2013: 760272
    PubMedGoogle Scholar
  • 40 Duty B, Waingankar N, Okhunov Z, Ben Levi E, Smith A, Okeke Z. Anatomical variation between the prone, supine, and supine oblique positions on computed tomography: implications for percutaneous nephrolithotomy access. Urology 2012; 79 (01) 67-71 . Doi: 10.1016/j.urology.2011.06.019
    CrossrefPubMedGoogle Scholar
  • 41 Jinga V, Dorobat B, Youssef S. , et al. Transarterial embolization of renal vascular lesions after percutaneous nephrolithotomy. Chirurgia (Bucur) 2013; 108 (04) 521-529
    PubMedGoogle Scholar
  • 42 Miano R, Scoffone C, De Nunzio C. , et al; International Translation Research in Uro-Sciences Team. Position: prone or supine is the issue of percutaneous nephrolithotomy. J Endourol 2010; 24 (06) 931-938 . Doi: 10.1089/end.2009.0571
    CrossrefPubMedGoogle Scholar
  • 43 Edgcombe H, Carter K, Yarrow S. Anaesthesia in the prone position. Br J Anaesth 2008; 100 (02) 165-183 . Doi: 10.1093/bja/aem380
    CrossrefPubMedGoogle Scholar
  • 44 Valdivia Uría JG, Lachares Santamaría E, Villarroya Rodríguez S, Taberner Llop J, Abril Baquero G, Aranda Lassa JM. [Percutaneous nephrolithectomy: simplified technic (preliminary report)]. Arch Esp Urol 1987; 40 (03) 177-180
    PubMedGoogle Scholar
  • 45 Pump B, Talleruphuus U, Christensen NJ, Warberg J, Norsk P. Effects of supine, prone, and lateral positions on cardiovascular and renal variables in humans. Am J Physiol Regul Integr Comp Physiol 2002; 283 (01) R174-R180 . Doi: 10.1152/ajpregu.00619.2001
    CrossrefPubMedGoogle Scholar
  • 46 Schonauer C, Bocchetti A, Barbagallo G, Albanese V, Moraci A. Positioning on surgical table. Eur Spine J 2004; 13 (Suppl. 01) S50-S55 . Doi: 10.1007/3-540-27394-8_8
    CrossrefPubMedGoogle Scholar
  • 47 Akhavan A, Gainsburg DM, Stock JA. Complications associated with patient positioning in urologic surgery. Urology 2010; 76 (06) 1309-1316 . Doi: 10.1016/j.urology.2010.02.060
    CrossrefPubMedGoogle Scholar
  • 48 Astroza G, Lipkin M, Neisius A. , et al. Outcomes of Percutaneous Nephrolithotomy Research Of fi ce of the Endourology Society. Urology 2013; DOI: 10.1016/j.urology.2013.06.068.
    PubMedGoogle Scholar
  • 49 Hopper KD, Sherman JL, Luethke JM, Ghaed N. The retrorenal colon in the supine and prone patient. Radiology 1987; 162 (02) 443-446
    CrossrefPubMedGoogle Scholar
  • 50 Rana AM, Bhojwani JP, Junejo NN, Das Bhagia S. Tubeless PCNL with patient in supine position: procedure for all seasons?--with comprehensive technique. Urology 2008; 71 (04) 581-585
    CrossrefPubMedGoogle Scholar
  • 51 Papatsoris AG, Masood J, Saunders P. Supine valdivia and modified lithotomy position for simultaneous anterograde and retrograde endourological access. BJU Int 2007; 100 (05) 1192 . Doi: 10.1111/j.1464-410X.2007.07248_3.x
    PubMedGoogle Scholar
  • 52 Llanes L, Sáenz J, Gamarra M. , et al. Reproducibility of percutaneous nephrolithotomy in the Galdakao-modified supine Valdivia position. Urolithiasis 2013; 41 (04) 333-340 . Doi: 10.1007/s00240-013-0558-7
    CrossrefPubMedGoogle Scholar
  • 53 Friedlander JI, Duty BD, Smith AD, Okeke Z. Percutaneous nephrostolithotomy: an assessment of costs for prone and Galdakao-modified supine Valdivia positioning. Urology 2012; 80 (04) 771-775 . Doi: 10.1016/j.urology.2012.06.038
    CrossrefPubMedGoogle Scholar
  • 54 Gupta M, Lee MW. Treatment of stones associated with complex or anomalous renal anatomy. Urol Clin North Am 2007; 34 (03) 431-441 . Doi: 10.1016/j.ucl.2007.04.004
    CrossrefPubMedGoogle Scholar
  • 55 Juan Y-S, Wu W-J, Chuang S-M. , et al. Management of symptomatic urolithiasis during pregnancy. Kaohsiung J Med Sci 2007; 23 (05) 241-246 . Doi: 10.1016/S1607-551X(09)70404-8
    CrossrefPubMedGoogle Scholar
  • 56 Landau EH. Modern Stone Management in Children. Eur Urol Suppl 2015; 14 (01) 12-19 . Doi: 10.1016/j.eursup.2015.01.004
    CrossrefPubMedGoogle Scholar
  • 57 Liu L, Zheng S, Xu Y, Wei Q. Systematic review and meta-analysis of percutaneous nephrolithotomy for patients in the supine versus prone position. J Endourol 2010; 24 (12) 1941-1946
    CrossrefPubMedGoogle Scholar
  • 58 Abdel-Mohsen E, Kamel M, Zayed AL. , et al. Free-flank modified supine vs. prone position in percutaneous nephrolithotomy: A prospective randomised trial. Arab J Urol 2013; 11 (01) 74-78
    CrossrefPubMedGoogle Scholar