Shifting the paradigm of percutaneous treatment for renal stones ; experience from a single tertiary care centre in Sri Lanka

Supine Percutaneous Nephrolithotomy (PCNL) is increasingly recognized as an effective and patient-friendly technique for managing complex renal calculi. This study evaluates the efficacy and treatment outcome of 32 supine PCNLs performed by a surgical trainee in a tertiary care hospital in Sri Lanka. Efficacy in view of operative time and stone free rates, outcome in view of postoperative complications were assessed.
Results demonstrated a high complete Stone Free Rate (SFR) of 87.5% with a mean operative time of 49.7 min. All the patients had double J stent in situ for 2 weeks and only one patient required a Percutaneous Nephrostomy (PCN) tube siting. Three patients developed minor postoperative complications. One was a febrile Urinary Tract Infection (UTI) managed with intravenous antibiotics; two patients developed haematuria which needed irrigation via 3-way catheter. None of the patients had colonic injury or developed bleeding which required blood transfusion.
Supine PCNL is a safe and effective technique which can be adopted with acceptable postoperative complication rates with comparable stone free rates. It provides potential advantages of reduced operative time, less patient handling and simultaneous ureteroscopic access.