Comparison of Supine and Prone Positions in PCNL Operations Performed in Isolated Kidney Upper Pole Access

Yusuf Arıkan; Serhat Beyan; Ömer Koraş; Mert Guroglu; Büşra Emir; Ferhat Demirci; Yavuz Danacıoğlu; Mehmet Zeynel Keskin

doi:10.35440/hutfd.1637397

Araştırma Makalesi

İzole Böbrek Üst Pol Akses Yapılan PCNL Operasyonlarında Supin ve Prone Pozisyonlarının Karşılaştırılmas

Yıl 2025, Cilt: 22 Sayı: 2, 338 - 343

Yusuf Arıkan , Serhat Beyan , Ömer Koraş , Mert Guroglu , Büşra Emir , Ferhat Demirci , Yavuz Danacıoğlu , Mehmet Zeynel Keskin

https://doi.org/10.35440/hutfd.1637397

Öz

Amaç: Üst pelvikalsiyel sistemde 2 cm’den büyük böbrek taşları genellikle Perkütan Nefrolitotomi (PCNL) operasyonu ile tedavi edilir ancak hangi pozisyonda olması gerektiği konusunda belirsizlikler vardır. Çalışmamızda supin ve prone pozisyonunda izole böbrek üst pol aksesi ile PCNL yapılan hastaların preoperatif-peroperatif ve postoperatif verilerinin karşılaştırılması amaçlanmıştır.
Materyal-Method: Çalışmaya böbrek üst polüne akses yapılan 20 Supin PCNL ve 45 Prone PCNL vakası dahil edildi. Hastaların demografik verileri, preoperatif bulguları, peroperatif verileri, postoperatif komplikasyon oranları ve operasyondan 1 ay sonra çekilen Non-Kontrast Bilgisayarlı Tomografi ile taşsızlık durumu değerlendirildi.
Bulgular: Her iki grupta demografik verilerden yaş, cinsiyet, VKİ, ASA skorları açısından herhangi bir istatistiksel fark izlenmedi. Peroperaif verilerden operasyon süresi supin PCNL grubunda 75.95±28.7 dk, prone PCNL grubunda 92.48±23.4 dk olup daha kısaydı (p<0.001). Akses ve floroskopi süresi ise Supin PCNL grubunda (11.6±5.12 dk ve 3.6±1.2 dk) prone PCNL’ye (9.2±3.7 dk ve 2.5±1.1 dk) göre istatistiksel olarak daha uzundu (p<0.001). Gruplar arasında komplikasyonlar açısından fark izlenmedi. Grade>2 komplikasyonlar Supin PCNL hastalarında daha sıktı (p:0.03). Taşsızlık açısından supin PCNL hastalarında %70, prone PNCL hastalarında %77.7 izlendi (p:0.01).
Sonuç: Üst pole akses ile yapılan PCNL operasyonlarında prone PCNL’de daha uzun operasyon süresi olsa da daha yüksek taşsızlık sağlanmaktadır. Prone PCNL’de Grade >2 komplikasyonlar daha az görülmektedir

Anahtar Kelimeler

PCNL, supin pozisyon, prone pozisyon, böbrek taşı, taş cerrahisi

Kaynakça

1. Zhang J, Luo H, Wu H, Qian Y, Tang Z, Wang J et al. The associa-tion between domestic water hardness and kidney stone dise-ase: a prospective cohort study from the UK Biobank. Int J Surg. 2024 Dec 31. doi: 10.1097/JS9.0000000000002198. Epub ahead of print. PMID: 39784501.
2. Cui D, Chen G, Luo J, Ma Q, Wang G, Yang Z, et al. Comparison of percutaneous nephrolithotripsy combined with retrograde intrarenal surgery and multi-tract percutaneous nephrolithot-ripsy for octopus stone: A propensity score-matching study. Medicine (Baltimore). 2024 May 31;103(22):e38311. doi: 10.1097/MD.0000000000038311. PMID: 39259108; PMCID: PMC11142782.
3. Gelmis M, Caglar U, Esmeray A, Gunay NF, Dizdaroglu C, Meric A et al. Comparison of supine and prone mini percutaneous nephrolithotomy in obese patients: a retrospective study. Ak-tuelle Urol. 2024 Sep 12. English. doi: 10.1055/a-2382-8423. Epub ahead of print. PMID: 39265637.
4. Zoeir A, Mamdoh H, Moussa A, Abdel-Raheem A, Gameel T, Elsherbeny A, et al. Which is easier for beginners: supine or prone position percutaneous nephrolithotomy? Assessment of the learning curve in novice urologists through a randomized clinical trial. Minerva Urol Nephrol. 2024 Dec;76(6):748-758. doi: 10.23736/S2724-6051.24.05974-3. PMID: 39831856.
5. Soares RMO, Zhu A, Talati VM, Nadler RB. Upper Pole Access for Prone Percutaneous Nephrolithotomy: Advantage or Risk? Urology. 2019 Dec;134:66-71. doi: 10.1016/j.urology.2019.08.031. Epub 2019 Sep 2. PMID: 31487511.
6. Bulut EC, Aydın U, Coşkun Ç, Çetin S, Ünsal A, Polat F, et al. Which Position for Novice Surgeons? Effect of Supine and Pro-ne Positions on Percutaneous Nephrolithotomy Learning Cur-ve. Medicina (Kaunas). 2024 Aug 10;60(8):1292. doi: 10.3390/medicina60081292. PMID: 39202573; PMCID: PMC11356003.
7. Heidar NA, Labban M, Nguyen DD, El-Achkar A, Mansour M, Bhojani N et al. Does volume matter? Incorporating estimated stone volume in a nomogram to predict ureteral stone passa-ge. Can Urol Assoc J. 2022 Mar;16(3):E150-E154. doi: 10.5489/cuaj.7364. PMID: 34672936; PMCID: PMC8923883.
8. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae. PMID: 15273542; PMCID: PMC1360123.
9. Huang T, Jiao BB, Luo ZK, Zhao H, Geng L, Zhang G. Evidence of the outcome and safety of upper pole vs. other pole access single puncture PCNL for kidney stones: which is better? Eur Rev Med Pharmacol Sci. 2023 May;27(10):4406-4420. doi: 10.26355/eurrev_202305_32446. PMID: 37259721.
10. Memik Ö, Karslı O. Assessment of complications and success rates of Percutaneous nephrolithotomy: single tract vs. multi tract approaches. PeerJ. 2025 Jan 16;13:e18450. doi: 10.7717/peerj.18450. PMID: 39830965; PMCID: PMC11742455.
11. Lojanapiwat B, Prasopsuk S. Upper-pole access for percutane-ous nephrolithotomy: comparison of supracostal and infracos-tal approaches. J Endourol. 2006 Jul;20(7):491-4. doi: 10.1089/end.2006.20.491. PMID: 16859462.
12. Tefekli A, Esen T, Olbert PJ, Tolley D, Nadler RB, Sun YH et al. Isolated upper pole access in percutaneous nephrolithotomy: a large-scale analysis from the CROES percutaneous nephrolit-hotomy global study. J Urol. 2013 Feb;189(2):568-73. doi: 10.1016/j.juro.2012.09.035. Epub 2012 Dec 20. PMID: 23260552.
13. Stening SG, Bourne S. Supracostal percutaneous nephrolitho-tomy for upper pole caliceal calculi. J Endourol. 1998 Aug;12(4):359-62. doi: 10.1089/end.1998.12.359. PMID: 9726403.
14. Golijanin D, Katz R, Verstandig A, Sasson T, Landau EH, Meretyk S. The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones. J Endourol. 1998 Oct;12(5):403-5. doi: 10.1089/end.1998.12.403. PMID: 9847059.
15. Khalil MAU, Patujo YH, Ullah F, Ibrar U, Adil R, Inam QA et al. An Analysis of Percutaneous Nephrolithotomy (PCNL) Perfor-med at the Institute of Kidney Disease, Pakistan: Stone Clea-rance and Complications. Cureus. 2024 Dec 9;16(12):e75430. doi: 10.7759/cureus.75430. PMID: 39791059; PMCID: PMC11711708.
16. Astroza G, Lipkin M, Neisius A, Preminger G, De Sio M, Sodha H, et al. Effect of supine vs prone position on outcomes of percutaneous nephrolithotomy in staghorn calculi: results from the Clinical Research Office of the Endourology Society Study. Urology. 2013 Dec;82(6):1240-4. doi: 10.1016/j.urology.2013.06.068. Epub 2013 Sep 21. PMID: 24063939.
17. Bulut EC, Aydın U, Coşkun Ç, Çetin S, Ünsal A, Polat F, et al. Which Position for Novice Surgeons? Effect of Supine and Pro-ne Positions on Percutaneous Nephrolithotomy Learning Cur-ve. Medicina (Kaunas). 2024 Aug 10;60(8):1292. doi: 10.3390/medicina60081292. PMID: 39202573; PMCID: PMC11356003.
18. Zhou G, Zhou Y, Chen R, Wang D, Zhou S, Zhong J, Zhao Y, Wan C, Yang B, Xu J, Geng E, Li G, Huang Y, Liu H, Liu J et al. The inf-luencing factors of infectious complications after percutane-ous nephrolithotomy: a systematic review and meta-analysis. Urolithiasis. 2022 Dec 14;51(1):17. doi: 10.1007/s00240-022-01376-5. PMID: 36515726; PMCID: PMC9750925.
19. Oner S, Karagozlu Akgul A, Demirbas M, Onen E, Aydos M, Erdogan A. Upper pole access is safe and effective for pediatric percutaneous nephrolithotomy. J Pediatr Urol. 2018 Apr;14(2):183.e1-183.e8. doi: 10.1016/j.jpurol.2017.12.013. Epub 2018 Feb 2. PMID: 29459134.
20. Sofer M, Giusti G, Proietti S, Mintz I, Kabha M, Matzkin H, et al. Upper Calyx Approachability through a Lower Calyx Access for Prone Versus Supine Percutaneous Nephrolithotomy. J Urol. 2016 Feb;195(2):377-82. doi: 10.1016/j.juro.2015.07.101. Epub 2015 Aug 6. PMID: 26254723.
21. Kumar N, Somani B. Supine tubeless upper pole PCNL under spinal anaesthesia: Safety, feasibility and outcomes from a ter-tiary endourology centre. Arab J Urol. 2024 Jan 26;22(3):159-165. doi: 10.1080/20905998.2024.2309780. PMID: 38818256; PMCID: PMC11136457.
22. Desoky EAE, Sakr AM, ElSayed ER, Ali MM. Ultra-Mini-Percutaneous Nephrolithotomy in Flank-Free Modified Supine Position vs Prone Position in Treatment of Pediatric Renal Pelvic and Lower Caliceal Stones. J Endourol. 2022 May;36(5):610-614. doi: 10.1089/end.2021.0557. Epub 2022 Mar 9. PMID: 34861776.
23. Jamil MN, Haq FU, Islam EU, Shaheen R, Farooq U. Comparison Between Supine Position Versus Prone Position In Percutane-ous Nephrolithotomy: A Single Centered Analysis Of 623 Cases. J Ayub Med Coll Abbottabad. 2022 Oct-Dec;34(Suppl 1)(4):S1003-S1007. doi: 10.55519/JAMC-04-S4-11259. PMID: 36550663.
24. Yuan D, Liu Y, Rao H, Cheng T, Sun Z, Wang Y et al. Versus Prone Position in Percutaneous Nephrolithotomy for Kidney Calculi: A Meta-Analysis. J Endourol. 2016 Jul;30(7):754-63. doi: 10.1089/end.2015.0402. Epub 2016 May 11. PMID: 27072075.
25. Birowo P, Tendi W, Widyahening IS, Rasyid N, Atmoko W. Supine versus prone position in percutaneous nephrolitho-tomy: a systematic review and meta-analysis. F1000Res. 2020 Apr 2;9:231. doi: 10.12688/f1000research.22940.3. PMID: 33014345; PMCID: PMC7509599.
26. Liu L, Zheng S, Xu Y, Wei Q. Systematic review and meta-analysis of percutaneous nephrolithotomy for patients in the supine versus prone position. J Endourol. 2010 Dec;24(12):1941-6. doi: 10.1089/end.2010.0292. Epub 2010 Sep 21. PMID: 20858062.
27. Kekre NS, Gopalakrishnan GG, Gupta GG, Abraham BN, Sharma E. Supracostal approach in percutaneous nephrolithotomy: experience with 102 cases. J Endourol. 2001 Oct;15(8):789-91. doi: 10.1089/089277901753205753. PMID: 11724115.
28. Radecka E, Brehmer M, Holmgren K, Magnusson A. Complicati-ons associated with percutaneous nephrolithotripsy: supra- versus subcostal access. A retrospective study. Acta Radiol. 2003 Jul;44(4):447-51. doi: 10.1080/j.1600-0455.2003.00083.x. PMID: 12846698.

Comparison of Supine and Prone Positions in PCNL Operations Performed in Isolated Kidney Upper Pole Access

Yıl 2025, Cilt: 22 Sayı: 2, 338 - 343

Yusuf Arıkan , Serhat Beyan , Ömer Koraş , Mert Guroglu , Büşra Emir , Ferhat Demirci , Yavuz Danacıoğlu , Mehmet Zeynel Keskin

https://doi.org/10.35440/hutfd.1637397

Öz

Background: Renal stones larger than 2 cm in the upper pelvical system are usually managed with Percutaneous Nephro-lithotomy (PCNL) operation, but there are unclear as to which position should be used. In our study, we aimed to compare the preoperative-peroperative and postoperative data of patients who underwent PCNL with isolated renal upper pole access in supine and prone position.
Materials and Methods: The study included 20 Supine PCNL and 45 Prone PCNL cases who underwent isolated renal upper pole access for renal calculi. Age, gender, body mass index (BMI) were evaluated from demographic data. Radiological findings such as stone-skin distance, stone density, stone size and volume were recorded. Total operation time, access time and fluoroscopy time were recorded from peroperative data. In the postoperative period, the duration of hospital stay and complications according to Clavien Dindo classification were recorded. Non-contrast computed tomography was performed at the 1st postoperative month and the stone-free status of the patients was evaluated.
Results: There was no statistical difference in demographic data in terms of age, gender, BMI, ASA scores in both groups. The total operation time was 75.95±28.7 min in supine PCNL group and 92.48±23.4 min in prone PCNL group (p<0.001). Access time was 11.6±5.12 min in supine PCNL group and 9.2±3.7 min in prone PCNL group (p<0.001). Fluoroscopy time was 3.6±1.2 min in the supine PCNL group and 2.5±1.1 min in the prone PCNL group and was statistically longer (p<0.001). There was no difference in complications between the groups. Grade>2 complications according to Clavien Dindo classification were more frequent in supine PCNL patients (p:0.03). Stone-free status was 70% in supine PCNL patients and 77.7% in prone PCNL patients and was higher in the prone PCNL group (p:0.01).
Conclusions: In patients undergoing PCNL for isolated upper pol stone, the operation time is longer when prone PCNL is performed, but higher stone-free rates are obtained in these patients. Grade >2 complications are less common in prone PCNL for renal upper pole calculi.

Anahtar Kelimeler

PCNL, supine position, prone position, renal calculi, stone surgery

Kaynakça

1. Zhang J, Luo H, Wu H, Qian Y, Tang Z, Wang J et al. The associa-tion between domestic water hardness and kidney stone dise-ase: a prospective cohort study from the UK Biobank. Int J Surg. 2024 Dec 31. doi: 10.1097/JS9.0000000000002198. Epub ahead of print. PMID: 39784501.
2. Cui D, Chen G, Luo J, Ma Q, Wang G, Yang Z, et al. Comparison of percutaneous nephrolithotripsy combined with retrograde intrarenal surgery and multi-tract percutaneous nephrolithot-ripsy for octopus stone: A propensity score-matching study. Medicine (Baltimore). 2024 May 31;103(22):e38311. doi: 10.1097/MD.0000000000038311. PMID: 39259108; PMCID: PMC11142782.
3. Gelmis M, Caglar U, Esmeray A, Gunay NF, Dizdaroglu C, Meric A et al. Comparison of supine and prone mini percutaneous nephrolithotomy in obese patients: a retrospective study. Ak-tuelle Urol. 2024 Sep 12. English. doi: 10.1055/a-2382-8423. Epub ahead of print. PMID: 39265637.
4. Zoeir A, Mamdoh H, Moussa A, Abdel-Raheem A, Gameel T, Elsherbeny A, et al. Which is easier for beginners: supine or prone position percutaneous nephrolithotomy? Assessment of the learning curve in novice urologists through a randomized clinical trial. Minerva Urol Nephrol. 2024 Dec;76(6):748-758. doi: 10.23736/S2724-6051.24.05974-3. PMID: 39831856.
5. Soares RMO, Zhu A, Talati VM, Nadler RB. Upper Pole Access for Prone Percutaneous Nephrolithotomy: Advantage or Risk? Urology. 2019 Dec;134:66-71. doi: 10.1016/j.urology.2019.08.031. Epub 2019 Sep 2. PMID: 31487511.
6. Bulut EC, Aydın U, Coşkun Ç, Çetin S, Ünsal A, Polat F, et al. Which Position for Novice Surgeons? Effect of Supine and Pro-ne Positions on Percutaneous Nephrolithotomy Learning Cur-ve. Medicina (Kaunas). 2024 Aug 10;60(8):1292. doi: 10.3390/medicina60081292. PMID: 39202573; PMCID: PMC11356003.
7. Heidar NA, Labban M, Nguyen DD, El-Achkar A, Mansour M, Bhojani N et al. Does volume matter? Incorporating estimated stone volume in a nomogram to predict ureteral stone passa-ge. Can Urol Assoc J. 2022 Mar;16(3):E150-E154. doi: 10.5489/cuaj.7364. PMID: 34672936; PMCID: PMC8923883.
8. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae. PMID: 15273542; PMCID: PMC1360123.
9. Huang T, Jiao BB, Luo ZK, Zhao H, Geng L, Zhang G. Evidence of the outcome and safety of upper pole vs. other pole access single puncture PCNL for kidney stones: which is better? Eur Rev Med Pharmacol Sci. 2023 May;27(10):4406-4420. doi: 10.26355/eurrev_202305_32446. PMID: 37259721.
10. Memik Ö, Karslı O. Assessment of complications and success rates of Percutaneous nephrolithotomy: single tract vs. multi tract approaches. PeerJ. 2025 Jan 16;13:e18450. doi: 10.7717/peerj.18450. PMID: 39830965; PMCID: PMC11742455.
11. Lojanapiwat B, Prasopsuk S. Upper-pole access for percutane-ous nephrolithotomy: comparison of supracostal and infracos-tal approaches. J Endourol. 2006 Jul;20(7):491-4. doi: 10.1089/end.2006.20.491. PMID: 16859462.
12. Tefekli A, Esen T, Olbert PJ, Tolley D, Nadler RB, Sun YH et al. Isolated upper pole access in percutaneous nephrolithotomy: a large-scale analysis from the CROES percutaneous nephrolit-hotomy global study. J Urol. 2013 Feb;189(2):568-73. doi: 10.1016/j.juro.2012.09.035. Epub 2012 Dec 20. PMID: 23260552.
13. Stening SG, Bourne S. Supracostal percutaneous nephrolitho-tomy for upper pole caliceal calculi. J Endourol. 1998 Aug;12(4):359-62. doi: 10.1089/end.1998.12.359. PMID: 9726403.
14. Golijanin D, Katz R, Verstandig A, Sasson T, Landau EH, Meretyk S. The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones. J Endourol. 1998 Oct;12(5):403-5. doi: 10.1089/end.1998.12.403. PMID: 9847059.
15. Khalil MAU, Patujo YH, Ullah F, Ibrar U, Adil R, Inam QA et al. An Analysis of Percutaneous Nephrolithotomy (PCNL) Perfor-med at the Institute of Kidney Disease, Pakistan: Stone Clea-rance and Complications. Cureus. 2024 Dec 9;16(12):e75430. doi: 10.7759/cureus.75430. PMID: 39791059; PMCID: PMC11711708.
16. Astroza G, Lipkin M, Neisius A, Preminger G, De Sio M, Sodha H, et al. Effect of supine vs prone position on outcomes of percutaneous nephrolithotomy in staghorn calculi: results from the Clinical Research Office of the Endourology Society Study. Urology. 2013 Dec;82(6):1240-4. doi: 10.1016/j.urology.2013.06.068. Epub 2013 Sep 21. PMID: 24063939.
17. Bulut EC, Aydın U, Coşkun Ç, Çetin S, Ünsal A, Polat F, et al. Which Position for Novice Surgeons? Effect of Supine and Pro-ne Positions on Percutaneous Nephrolithotomy Learning Cur-ve. Medicina (Kaunas). 2024 Aug 10;60(8):1292. doi: 10.3390/medicina60081292. PMID: 39202573; PMCID: PMC11356003.
18. Zhou G, Zhou Y, Chen R, Wang D, Zhou S, Zhong J, Zhao Y, Wan C, Yang B, Xu J, Geng E, Li G, Huang Y, Liu H, Liu J et al. The inf-luencing factors of infectious complications after percutane-ous nephrolithotomy: a systematic review and meta-analysis. Urolithiasis. 2022 Dec 14;51(1):17. doi: 10.1007/s00240-022-01376-5. PMID: 36515726; PMCID: PMC9750925.
19. Oner S, Karagozlu Akgul A, Demirbas M, Onen E, Aydos M, Erdogan A. Upper pole access is safe and effective for pediatric percutaneous nephrolithotomy. J Pediatr Urol. 2018 Apr;14(2):183.e1-183.e8. doi: 10.1016/j.jpurol.2017.12.013. Epub 2018 Feb 2. PMID: 29459134.
20. Sofer M, Giusti G, Proietti S, Mintz I, Kabha M, Matzkin H, et al. Upper Calyx Approachability through a Lower Calyx Access for Prone Versus Supine Percutaneous Nephrolithotomy. J Urol. 2016 Feb;195(2):377-82. doi: 10.1016/j.juro.2015.07.101. Epub 2015 Aug 6. PMID: 26254723.
21. Kumar N, Somani B. Supine tubeless upper pole PCNL under spinal anaesthesia: Safety, feasibility and outcomes from a ter-tiary endourology centre. Arab J Urol. 2024 Jan 26;22(3):159-165. doi: 10.1080/20905998.2024.2309780. PMID: 38818256; PMCID: PMC11136457.
22. Desoky EAE, Sakr AM, ElSayed ER, Ali MM. Ultra-Mini-Percutaneous Nephrolithotomy in Flank-Free Modified Supine Position vs Prone Position in Treatment of Pediatric Renal Pelvic and Lower Caliceal Stones. J Endourol. 2022 May;36(5):610-614. doi: 10.1089/end.2021.0557. Epub 2022 Mar 9. PMID: 34861776.
23. Jamil MN, Haq FU, Islam EU, Shaheen R, Farooq U. Comparison Between Supine Position Versus Prone Position In Percutane-ous Nephrolithotomy: A Single Centered Analysis Of 623 Cases. J Ayub Med Coll Abbottabad. 2022 Oct-Dec;34(Suppl 1)(4):S1003-S1007. doi: 10.55519/JAMC-04-S4-11259. PMID: 36550663.
24. Yuan D, Liu Y, Rao H, Cheng T, Sun Z, Wang Y et al. Versus Prone Position in Percutaneous Nephrolithotomy for Kidney Calculi: A Meta-Analysis. J Endourol. 2016 Jul;30(7):754-63. doi: 10.1089/end.2015.0402. Epub 2016 May 11. PMID: 27072075.
25. Birowo P, Tendi W, Widyahening IS, Rasyid N, Atmoko W. Supine versus prone position in percutaneous nephrolitho-tomy: a systematic review and meta-analysis. F1000Res. 2020 Apr 2;9:231. doi: 10.12688/f1000research.22940.3. PMID: 33014345; PMCID: PMC7509599.
26. Liu L, Zheng S, Xu Y, Wei Q. Systematic review and meta-analysis of percutaneous nephrolithotomy for patients in the supine versus prone position. J Endourol. 2010 Dec;24(12):1941-6. doi: 10.1089/end.2010.0292. Epub 2010 Sep 21. PMID: 20858062.
27. Kekre NS, Gopalakrishnan GG, Gupta GG, Abraham BN, Sharma E. Supracostal approach in percutaneous nephrolithotomy: experience with 102 cases. J Endourol. 2001 Oct;15(8):789-91. doi: 10.1089/089277901753205753. PMID: 11724115.
28. Radecka E, Brehmer M, Holmgren K, Magnusson A. Complicati-ons associated with percutaneous nephrolithotripsy: supra- versus subcostal access. A retrospective study. Acta Radiol. 2003 Jul;44(4):447-51. doi: 10.1080/j.1600-0455.2003.00083.x. PMID: 12846698.

Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Üroloji
Bölüm	Araştırma Makalesi
Yazarlar	Yusuf Arıkan 0000-0003-0823-7400 Serhat Beyan 0009-0007-5604-7958 Ömer Koraş 0000-0001-9749-5254 Mert Guroglu 0009-0001-3311-3402 Büşra Emir 0000-0003-4694-1319 Ferhat Demirci 0000-0002-5999-3399 Yavuz Danacıoğlu 0000-0002-3170-062X Mehmet Zeynel Keskin 0000-0002-9206-5586
Erken Görünüm Tarihi	11 Haziran 2025
Yayımlanma Tarihi
Gönderilme Tarihi	11 Şubat 2025
Kabul Tarihi	24 Mayıs 2025
Yayımlandığı Sayı	Yıl 2025 Cilt: 22 Sayı: 2

Kaynak Göster

Vancouver	Arıkan Y, Beyan S, Koraş Ö, Guroglu M, Emir B, Demirci F, Danacıoğlu Y, Keskin MZ. Comparison of Supine and Prone Positions in PCNL Operations Performed in Isolated Kidney Upper Pole Access. Harran Üniversitesi Tıp Fakültesi Dergisi. 2025;22(2):338-43.

Makale Dosyaları

Tam Metin

Harran Üniversitesi Tıp Fakültesi Dergisi _/Journal of Harran University Medical Faculty