To compare the safety and effect of breaststroke position and traditional prone position of percutaneous nephrolithotomy (PCNL) in the treatment of upper urinary tract calculi.

The clinical data of 147 patients with renal calculi or upper ureteral calculi who underwent PCNL surgery in the Fifth Affiliated Hospital of Sun Yat-sen University from June 2019 to June 2020 were analyzed retrospectively. According to the different surgical positions during the operation, the patients were divided into the breaststroke position group and the traditional prone position group. The distance from the lower edge of the left twelfth rib to the lowest edge of the kidney, the distance from the back of the waist to the posterior edge of the kidney, the time to establish the channel, the operation time, the rate of multi-channel, the incidence of complications and the stone removal rate were compared between the two groups.

Compared with the traditional position group, in the breaststroke position group, the distance from the lower edge of the 12th rib to the lowest edge of the kidney was longer (P=0.006), the distance from the body surface of the back of the waist to the plane of the posterior edge of the kidney was shorter (P=0.020), the time to establish the channel was shorter (P<0.001), the operation time was shorter (P=0.031), and the rate of multi-channel was lower (P=0.027). There were no significant differences in stone clearance rate (P=0.751), complication rate (P=0.109), and total length of hospital stay (P=0.188) between the two groups.

In the treatment of upper urinary tract calculi, the breaststroke position can improve the efficiency of PCNL.