RecruitingNot ApplicableNCT07138872

Hemodynamic Effects of Surgical Position in Prone vs. Supine Percutaneous Nephrolithotomy

The Effect of Surgical Position on Hemodynamics in Percutaneous Nephrolithotomy Performed in Prone and Supine Positions

Sponsor

Gaziosmanpasa Research and Education Hospital

Enrollment

84 participants

Start Date

Jun 1, 2025

Study Type

INTERVENTIONAL

Conditions

Prone Position Nephrolithiasis hemodynamic stability Percutaneous Nephrolithotomy (PCNL)Surgical Positioning Supine Position

Summary

This prospective, randomized controlled study evaluates the hemodynamic effects of prone and supine positions during percutaneous nephrolithotomy (PNL) for large kidney stones. Surgical position may influence intraoperative and postoperative hemodynamic stability. Prone positioning can increase intrathoracic pressure and reduce venous return, whereas supine positioning may provide greater hemodynamic stability. A total of 84 patients will be randomized to undergo PNL in prone or supine positions. Primary outcomes include changes in hemodynamic parameters during surgery. Results may guide surgical position selection, especially in patients with potential hemodynamic risk.

Eligibility

Min Age: 18 YearsMax Age: 80 Years

Plain Language Summary

Simplified for easier understanding

This clinical trial is studying a procedure called Prone Position Percutaneous Nephrolithotomy and a procedure called Supine Position Percutaneous Nephrolithotomy (Galdakao-modified Valdivia) for people with nephrolithiasis, percutaneous nephrolithotomy (pcnl), and other related conditions. The study is currently recruiting participants at 1 location. People eligible for this study include aged 18 Years to 80 Years.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

PROCEDUREProne Position Percutaneous Nephrolithotomy

Patients in this arm will undergo percutaneous nephrolithotomy (PNL) in the prone position. The procedure begins with ureteral catheter placement in lithotomy position, followed by prone positioning for renal access under C-arm fluoroscopic guidance. Stone fragmentation will be performed using pneumatic or ultrasonic lithotripters, and nephrostomy placement will be completed according to standard protocol.

PROCEDURESupine Position Percutaneous Nephrolithotomy (Galdakao-modified Valdivia)

Patients in this arm will undergo percutaneous nephrolithotomy (PNL) in the Galdakao-modified Valdivia supine position. Following general anesthesia, the ipsilateral side will be elevated 20-30°, with the ipsilateral leg extended and the contralateral leg abducted. Ureteral catheter placement will be followed by renal access under C-arm fluoroscopy. Stone fragmentation and removal will be performed using the same standardized lithotripsy and irrigation protocols as in the prone group.