Percutaneous nephrolithotomy in a semi-lateral position

Purpose: In the treatment of large-sized renal stones, percutaneous nephrolithotomy (PNL) is regarded as a minimally invasive surgery with an easy postoperative recovery. In previous procedures, which were done with the patient in a prone position, appropriate measures could not be taken in cases in which a cardiopulmonary emergency appeared. Given this background, we performed PNL in a manner to which the department of urology was accustomed. Then, we attempted to assess the treatment effect and safety of PNL on the basis of our clinical experiences. Materials and Methods: This study was conducted in 14 patients who underwent PNL in a semi-lateral position at our medical institution between April and October of 2008. The complete removal of renal stones, blood transfusion, the period of use of a catheter for nephrostomy, complications, and the need for additional procedures after the surgery were examined. Results: Six patients had stones in the pelvis, three had stones in the lower calyx, and five had multiple stones or pelvocalyceal stones. The mean stone size was 2.66 cm (range, 1.56-6.37 cm). In all patients, the renal stone was completely removed and post-procedure complications were minimal except for blood transfusion in one patient. No additional procedures were required in any of the patients. Conclusions: PNL was performed in a semi-lateral position, which is a position to which the department of urology is accustomed. By use of this position, surgeons and anesthesiologists can reduce the surgical burden due to posture. Based on our clinical experiences, PNL in a semi-lateral position is an effective, safe modality.