Abstract
To compare percutaneous nephrolithotomy (PNL) performed in the supine position with PNL performed in the prone position in terms of efficacy and safety in elderly patients with staghorn kidney stones. The data of patients over 65 years who underwent PNL surgery due to staghorn stones at our clinic between 2012 and 2022 was retrospectively screened. Complications were listed according to the modified Clavien-Dindo grading system, along with demographic characteristics and intraoperative and postoperative data. The patients were followed up for one month, during which their stone-free status was recorded. Of the total of 112 patients, 48 (42.9%) underwent supine PNL (Group-1) and 64 (57.1%) underwent prone PNL (Group-2). There were no statistically significant differences between the two groups in terms of demographic characteristics or stone characteristics (p>0.05). The number of pelvicalyceal accesses, operation time, hemoglobin decrease, blood transfusion rate, length of hospital stay, and complication rate were statistically significantly higher in Group-2 compared to Group-1 (p<0.05). However, the groups did not statistically significantly differ in relation to the change in blood creatinine value, stone-free status, or final stone-free status (p>0.05). PNL, in both supine and prone positions, is a safe and effective method for the treatment of kidney stones in elderly patients. The advantages of the supine position compared to the prone position in these patients are fewer complications, a lower transfusion rate, and a shorter operating time.