Endoüroloji Bülteni

Yazarlar: Yusuf ÖZLÜLERDEN ÖZLÜLERDEN, Ömer Levent TUNCAY

Konular:Üroloji ve Nefroloji

Anahtar Kelimeler:Percutaneous nephrolithotomy,Prone,Supine,Kidney,Stone disease

Özet: Percutaneous nephrolithotomy (PNL) is the first treatment method of choice for kidney stones over 2 cm, multiple kidney stones and staghorn type kidney stones. The standard patient position in PNL is prone position. Prone position provides a wide area both at the entrance to the kidney and it also provides an advantage during the operation after entering the kidney. The aim of this review is to evaluate the prone PNL with new literature. When Prone PNL and supine PNL current studies are examined, both had similar stone-free rates, similar organ injuries, urine leakage and general complication rates. Prone PNL is more prominent with its safety, efficacy and lower complication rates, especially in obese patients, patients with spinal anesthesia where pain palliation is important, patients requiring multiple accesses and patients scheduled for simultaneous bilateral PNL. Although the number of studies for supine PNL is increasing due to some advantages, it is not proved that safe and more successful than prone PNL. Prone PNL is the most preferred by many urologists because it provides easy access and dilatation collage, provides a wider operative area, is more comfortable for multiple entrances, is safe in obese or morbid obese patients,and is easier to access and is safer in anomaly kidneys such as horseshoe kidneys. It also comes to the forefront with the experience and implementation rate gained over the years. In Prone PNL, the identification of techniques that provide new accessories and the use of combined RIRS show that the method is still open to development. Therefore, it should be kept in mind that although prone PNL seems to be an old method, it is an obsolete method.

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