Prone versus supine positioning during percutaneous kidney stone removal (PCNL)
The Effect of Surgical Position on Hemodynamics in Percutaneous Nephrolithotomy Performed in Prone and Supine Positions
This trial will test whether doing PCNL with the patient prone or supine gives more stable blood pressure and heart function during surgery for adults with large kidney stones.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 84 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | Gaziosmanpasa Research and Education Hospital Government |
| Locations | 1 site (Istanbul) |
| Trial ID | NCT07138872 on ClinicalTrials.gov |
What this trial studies
This randomized controlled trial will enroll 84 adults (18–80 years, ASA I–III) undergoing elective percutaneous nephrolithotomy and randomly assign them to prone or supine (Galdakao-modified Valdivia) positioning. Intraoperative and postoperative hemodynamic parameters (blood pressure, heart rate, and related measures) will be recorded and compared between groups. Patients with pregnancy, uncontrolled coagulopathy, prior renal surgery, severe cardiorespiratory or neurologic disease, active urinary infection, or specified operative exclusions are not eligible. Results aim to clarify whether one position provides more stable cardiovascular status during and after PCNL and to inform position choice for patients at hemodynamic risk.
Who should consider this trial
Good fit: Adults aged 18–80 with renal calculi appropriate for PCNL and ASA physical status I–III who are scheduled for elective single-tract PCNL and meet the study's eligibility criteria are ideal candidates.
Not a fit: Patients who are pregnant, have uncontrolled coagulopathy, prior renal surgery, severe cardiac, pulmonary, or neurological disease, active urinary infection, require multiple access tracts, had a recent preoperative transfusion, or whose surgery is expected to last under 60 minutes or over 120 minutes are excluded and unlikely to benefit.
Why it matters
Potential benefit: If successful, the trial could identify the positioning approach that reduces intraoperative cardiovascular instability and perioperative complications, improving safety for patients with large kidney stones.
How similar studies have performed: Prior physiologic studies and small series suggest prone positioning can raise intrathoracic pressure and reduce venous return while supine may be more hemodynamically stable, but direct comparative randomized data are limited and remain inconclusive.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * ASA physical status I-III * Presence of renal calculi indicated for PNL Exclusion Criteria: * Pregnancy * Uncontrolled coagulopathy * Previous renal surgery * Severe cardiac, pulmonary, or neurological disease * Preoperative urinary tract infection (non-sterile urine culture) * Surgery duration \<60 minutes or \>120 minutes * Preoperative blood transfusion * Multiple access tracts
Where this trial is running
Istanbul
- Gaziosmanpaşa Training and Research Hospital — Istanbul, Turkey (Türkiye) (Recruiting)
Study contacts
- Study coordinator: Ari̇f Burak Keçebaş, Urology Clinic Doctor
- Email: arifkecebas@gmail.com
- Phone: +90 5412659978
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.