Prone CT Is Associated With Improved Safety and Stone-Free Outcomes in Prone PCNL: A Propensity-Matched Comparative...

Area of Science:

• Urology
• Medical Imaging
• Nephrolithiasis Management

Background:

• Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
• Patient positioning during preoperative computed tomography (CT) may influence PCNL outcomes.
• Evaluating the impact of CT positioning on perioperative results is crucial for optimizing surgical planning.

Purpose of the Study:

• To compare perioperative outcomes in patients undergoing prone PCNL based on preoperative CT positioning (prone vs. supine).
• To determine if prone-position CT is associated with improved surgical efficiency and safety in PCNL.

Main Methods:

• Single-center retrospective study of patients undergoing prone PCNL (June 2021-January 2024).
• Patients grouped by preoperative CT position (prone vs. supine).
• Propensity score matching (1:1) used to control for baseline differences, followed by comparison of operative time, tracts, stone-free rate (SFR), and complications.

Main Results:

• Prone CT group showed significantly shorter operative times (79.55 vs. 86.74 min, P=0.004).
• Fewer percutaneous tracts (1.10 vs. 1.27, P=0.021) and higher primary SFR (83.9% vs. 67.7%, P=0.036) were observed with prone CT.
• The prone CT group had a lower overall complication rate (3/62 vs. 10/62, P=0.040) with no pleural injuries.

Conclusions:

• Prone CT appears to enhance tract planning and improve early perioperative outcomes in selected patients undergoing prone PCNL.
• These findings suggest potential benefits of prone CT for optimizing PCNL procedures.
• Further prospective studies are needed to confirm these hypothesis-generating results.