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

NCT07138872 · Status: RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 84

Last updated 2025-08-24

No results posted yet for this study

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.

Conditions

  • Percutaneous Nephrolithotomy (PCNL)
  • Surgical Positioning
  • Prone Position
  • Supine Position
  • Hemodynamic Stability
  • Nephrolithiasis

Interventions

PROCEDURE

Prone 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.

PROCEDURE

Supine 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.

Sponsors & Collaborators

  • Gaziosmanpasa Research and Education Hospital

    lead OTHER_GOV

Principal Investigators

  • Burak Arslan, CLINICAL PROFESSOR OF UROLOGY · Gaziosmanpaşa Training and Research Hospital, Urology Department, Istanbul, Türkiye

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Model
PARALLEL

Eligibility

Min Age
18 Years
Max Age
80 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2025-06-01
Primary Completion
2025-12-30
Completion
2025-12-30

Countries

  • Turkey (Türkiye)

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07138872 on ClinicalTrials.gov