Comparison Of Prone Split-leg Position And Prone Position Percutaneous Nephrolithotomy For Upper Urinary Calculi

Objective:in the treatment of upper urinary calculi,compared the clinic data of the patient with percutaneous nephrolithotomy in the prone split-leg position and the prone position,to explore feasibilty,effectiveness and superiority of prone split-leg position.Methods:A total of 62 patients with upper urinary calculi who underwent PCNL during October 2017 to December 2019 were retrospectively analyzed.30 patients in the observation group with prone split-leg position,32 patients in the control group with traditional prone position.retrograde ureteral catheterization was done in prone splitleg position and under ultrasonographic guidance 18-24 F percutaneous access tract was established.11.2 Fr nephroscope was introduced through the access tract,using pneumatic ballistics lithotripsy,or holmium laser lithotripsy,etc.with the cooperation of perfusion pump to flushed out the stone.While in the control group,retrograde ureteral catheterization was performed at calculous position,the patient then transferred to the prone position to complete the subsequent surgical procedure.Stone-free rate,operation time,the time of establishment the tract and prepare position,blood loss,the duration of hospitalizations,fees,complication rate were analyzed.Results: PCNL was performed successfully in both groups.the operation time was 123.03±36.07 min in the prone split-leg position and 147.69±44.70 min in the prone position,the difference was statistically significant(p<0.05).The time of establishment the tract and prepare position were 33.44±15.83 min in prone split-leg position and 57.60 ± 9.58 min in prone position,the difference was statistically significant(p<0.05).There was no statistical difference between the stone-free rate,blood loss,the duration of hospitalizations,fees,complication rate(p >0.05).Conclusion:in the treatment with upper urinary calculi,using the prone split-leg PCNL is effective and feasible.It reduced the operation time,the time of establishment the tract and prepare position,and this position can combine URSL or FURL,also has good surgical outcomes.