Is the Supine Position Superior to the Prone Position for Percutaneous Nephrolithotomy (PCNL)?

Overview

Journal Urolithiasis

Publisher Springer

Specialty Urology

Date 2013 Oct 22

PMID 24141694

Citations 19

Authors

Xiaohua Zhang

Leilei Xia

Tianyuan Xu

Xianjin Wang

Shan Zhong

Zhoujun Shen

Affiliations

Soon will be listed here.

Abstract

The objective of this study is to update the two previous meta-analyses in order to evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for patients in the prone position versus supine position. An electronic database search of MEDLINE, EMBASE, google scholar, and the Cochrane library was performed up to June, 2013. All studies comparing prone with supine position for PCNL were included. The outcome measures were stone-free rate, operative time, complication and hospital stay. Two randomized controlled trials (RCTs) and 7 non-RCTs, including 6,413 patients (4,956 patients in the prone position group and 1,457 patients in the supine position group), met the inclusion criteria. Meta-analysis of extractable data showed that PCNL in the supine position was associated with a significantly shorter operative time (WMD: 21.7; 95% CI 2.46-40.94; p = 0.03) but lower stone-free rate (OR: 1.36; 95% CI 1.19-1.56; p < 0.0001) than PCNL in the prone position. There was no difference between the two positions regarding hospital stay (WMD = 0.05; 95% CI -0.16-0.25; p = 0.66) and complication rate (OR: 1.1; 95% CI 0.94-1.28; p = 0.24). In conclusion, the present study found different results from the two previous meta-analyses results regarding stone-free rate; PCNL in the supine position had a significantly lower stone-free rate than that in prone position.

Citing Articles

An updated systematic review and meta-analysis on the efficacy of supine versus prone position for pediatric PCNL.

Fang H, Zhu F, Cui K, Liu X, Wu S, Hua Y Int Urol Nephrol. 2025; .

PMID: 39971864 DOI: 10.1007/s11255-025-04428-y.

Analyzing learning curve for supine percutaneous nephrolithotomy in urology resident training programme: comparative analysis.

Arikan Y, Danacioglu Y, Ozlu D, Koras O, Emir B, Keskin M Urolithiasis. 2024; 52(1):129.

PMID: 39249559 DOI: 10.1007/s00240-024-01624-w.

Oblique supine position versus prone position for percutaneous nephrolithotomy: a systematic review and meta-analysis.

Wang H, Yang Z, Chang X, Wang Y, Li J, Han Z Wideochir Inne Tech Maloinwazyjne. 2023; 18(2):244-253.

PMID: 37680735 PMC: 10481440. DOI: 10.5114/wiitm.2023.126453.

Effect of patient positioning on anesthesiologic risk in endourological procedures.

Vrettos T, Ballesta Martinez B, Tsaturyan A, Liourdi D, Al-Aown A, Lattarulo M Urol Ann. 2023; 15(3):261-265.

PMID: 37664107 PMC: 10471805. DOI: 10.4103/ua.ua_113_22.

Which position is more advantageous for percutaneous nephrolithotomy: supine or prone?.

Kucukyangoz M, Gucuk A Urolithiasis. 2023; 51(1):102.

PMID: 37578662 DOI: 10.1007/s00240-023-01474-y.

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