Endoscopic combined intrarenal surgery in the prone split-leg position versus Galdakao-modified supine Valdivia position for the management of partial staghorn calculi

BMC Urol. 2022 Oct 20;22(1):163. doi: 10.1186/s12894-022-01115-3.

Abstract

Objective: To evaluate and compare the outcome of ECIRS in the treatment of partial staghorn renal calculi in both prone split-leg positions versus GMSV positions with regard to; technical aspects, success rate, operative time, complications, safety, and effectiveness of both approaches.

Patients and methods: Between October 2018 and August 2021, 66 patients with partial staghorn calculi were enrolled in this prospective comparative study. Patients were randomly divided according to a 1:1 ratio into two groups. Group A included 33 patients who were treated by (ECIRS) in the prone split-leg position, and group B included 33 patients who were treated by (ECIRS) in the Galdakao-modified supine Valdivia (GMSV) position.

Results: No significant statistical difference between both groups regarding the mean age (p = 0.448), mean body mass index (BMI) (p = 0.137), mean stone burden (p = 0.435), mean operative time (p = 0.541) and the number of calyces located in branched stones (p = 0.628). The mean hospital stay was 6.71 ± 1.12 days for group A and 6.66 ± 1.10 days for group B patients (p = 0.724). The final SFR was achieved in (29)87.87% and (30)90.9% of group A & B patients, respectively (p = 0.694). No significant difference was detected between both groups in perioperative complication rates.

Conclusion: ECIRS is safe and effective in treating partial staghorn calculi either in the prone split-leg position or in the Galdakao-modified supine Valdivia position, with comparable outcomes and no statistically significant difference between both positions.

Keywords: Intrarenal surgery; Prone; Staghorn; Supine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Humans
  • Kidney Calculi* / etiology
  • Kidney Calculi* / surgery
  • Leg
  • Nephrostomy, Percutaneous* / adverse effects
  • Prospective Studies
  • Staghorn Calculi* / surgery
  • Supine Position
  • Treatment Outcome