Supine Percutaneous Nephrolithotomy

Ain Shams University70 enrolled

Overview

there is an increased incidence of renal stones, especially in the pediatric age group. the percutaneous approach in the pediatric age took a long time till it again accepted among surgeons worldwide. the prone position is the preferred approach to perform percutaneous nephrolithotomy in the pediatric age group. this study aims to compare supine versus prone position percutaneous nephrolithotomy in the pediatric age group.

The incidence of renal stones in the pediatric age group increased from 18.4 to 57.0% per100,000 children in the period from 1999 to 2008. The acceptance of PCNL in pediatrics was slow at first due to concerns of the small kidney size compared to relatively large instruments percutaneous nephrolithotomy in pediatric patients was conventionally performed in the prone position for historical reasons, being more familiar to surgeons and it was considered safer to avoid colonic injury. Supine PCNL has several valuable advantages to pediatric patients in particular better irrigation shorter operative time with a comparable outcome with the prone position. our study aims to assess the efficacy and the safety of percutaneous nephrolithotomy in the supine position in comparison to the prone position in the pediatric age group.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Renal Stone

Interventions

percutaneous nephrolithotomy (supine position)PROCEDURE

percutaneous nephrolithotomy to be done in the supine position

percutaneous nephrolithotomy ( prone position)PROCEDURE

percutaneous nephrolithotomy in the prone position

Eligibility

Sex: ALLMin age: 2 YearsMax age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients aged from two to sixteen years old with single or multiple renal stones indicated for percutaneous nephrolithotomy Exclusion Criteria: * patients with renal anomalies, bleeding tendency, elevated kidney function tests for age, previous renal surgical intervention on the same site of intervention. * patients with skeletal abnormalities and spine deformities were also excluded * patients with a single kidney were also excluded

Locations (1)

Ain Shams University hospital

Cairo, Egypt

Outcomes

Primary Outcomes

stone free rate

evaluation of our patients after surgery with Xray or CT to detect residual stones

Time frame: first day postoperative

Secondary Outcomes

Fluoroscopy time during the procedure in minutes

time of fluoroscopy exposure in minutes intraoperative, time of radiational exposure during the surgery. operative finding only

Time frame: intraoperative finding in minutes,

operative time of the procedure in minutes

time from patient positioning till the end of the procedure, operative finding only

Time frame: intraoperative finding in minutes,

rate of Hemoglobin drop

change in the perioperative hemoglobin level

Time frame: day 1 post operative

hospital stay

days of hospital stay after the surgery

Time frame: first 2 days post surgery

incidence of urinary tract infection

presence of manifested urinary tract infection in our patient

Time frame: first 7 days post surgery

urine leakage

urine leakage from the percutaneous renal tract

Time frame: first 3 days postoperative

irrigation fluid usage

amount of irrigation fluid used during the surgery in liters

Time frame: intraoperative finding

Data from ClinicalTrials.gov

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