Clinical application of PCNL in oblique supine lithotomy position for upper urinary calculi

Objective: To investigate the effect of PCNL (Percutaneous Nephrolithotomy) in the treatment of upper urinary tract calculi in oblique supine lithotomy position and prone position. Methods: Retrospectively collected data from 184 patients and 80 patients who underwent PCNL in prone and oblique supine lithotomy position respectively in our hospital from 2016 to 2019. The intraoperative and postoperative observation indicators were compared to evaluate the advantages and disadvantages of oblique supine lithotomy position. Results: A total of 264 patients were recruited, PCNL in the treatment of upper urinary tract calculi in oblique supine lithotomy position (n=80) compared to prone position (n=184) had significantly shorter operation time (49.03±12.64min, 62.14±14.82min, P=0.032), higher stone removal rate in first week (82.5%>69.0%,P=0.023), lower Hb (Hemoglobin) reduction (9.94±3.62,12.83±4.01,P<0.01) and lower possibility of fever (8.7%,25.5%,P=0.002); patients who underwent PCNL in oblique supine lithotomy position had significantly lower renal pelvis pressure(18.70 ± 4.06mmHg, 26.28 ± 3.42mmHg, P <0.01)AT the same time, PCT (Postoperative inflammatory markers) were significantly increased when intraoperative renal pelvis hypertension occurred and the duration was more than 5min Conclusion: The oblique supine lithotomy position was associated with shorter operation time, lower renal pelvis pressure, incidence of postoperative related complications and combination of percutaneous nephroscope with ureteroscope under special condition, which is of great significance.