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Contralateral knee-flexion prone split-leg percutaneous nephrolithotomy: A versatile technique.

Shuhang Luo1, Xuanfan Liu2, Nueraili Nuermaimaiti2

  • 1Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

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A new knee-flexion prone split-leg (KF-PSL) position for percutaneous nephrolithotomy (PCNL) significantly reduces operative time and improves stone-free rates compared to the traditional prone position. This novel technique offers a safer and more efficient approach to kidney stone removal.

Keywords:
Kidney stonePercutaneous nephrolithotomyProne positionProne split-leg positionRetrospective study

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Area of Science:

  • Urology
  • Surgical Innovation
  • Nephrolithiasis Management

Background:

  • Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
  • Traditional prone (TP) and split-leg (PSL) positions have limitations.
  • A novel knee-flexion prone split-leg (KF-PSL) position was developed to overcome these challenges.

Purpose of the Study:

  • To develop and evaluate a novel KF-PSL position for PCNL.
  • To compare the safety, advantages, and feasibility of KF-PSL versus TP positions.
  • To assess the impact on operative time, stone-free rates, and complications.

Main Methods:

  • Retrospective analysis of 276 patients undergoing PCNL.
  • Patients were divided into KF-PSL and TP groups.
  • Demographic and perioperative data were collected and compared.

Main Results:

  • No significant difference in preoperative parameters or Braden Scale scores.
  • KF-PSL group showed significantly shorter operative time (80.9 min vs. 107.3 min).
  • KF-PSL group achieved a higher stone-free rate (73% vs. 61%) with no significant difference in total complication rates.

Conclusions:

  • The KF-PSL position is a promising modification for PCNL.
  • It offers reduced operative time and improved stone-free rates compared to TP.
  • This position simplifies the procedure and facilitates combined therapies without compromising outcomes.