This prospective cohort study aims to compare the incidence of Myocardial Injury after Noncardiac Surgery (MINS) in patients undergoing percutaneous nephrolithotomy (PNL) for kidney stones in supine versus prone positioning. MINS is defined as an elevated postoperative troponin level (≥0.03 ng/mL) within 48 hours after surgery. Approximately 400 patients will be enrolled, with 200 patients in each positioning group (supine and prone). The primary outcome is the incidence of MINS, assessed through troponin measurements and electrocardiogram (ECG) findings. Secondary outcomes include intraoperative complications, duration of surgery, and postoperative recovery metrics. The study seeks to determine whether surgical positioning impacts MINS risk, potentially guiding safer surgical practices.
Age ≥40 years.
Patients undergoing percutaneous nephrolithotomy (PNL) for kidney stones.
Willing and able to provide informed consent.
Known coronary artery disease, heart failure, or other significant cardiovascular conditions.
Elevated preoperative troponin levels (≥0.03 ng/mL).
Major intraoperative complications (e.g., severe bleeding requiring transfusion).
Inability to comply with study procedures.
Parallel
blood sampling
Diagnostic testmeasuring troponine preoperative and postoperative first and second day
Incidence of Myocardial Injury after Noncardiac Surgery (MINS)
Proportion of patients with postoperative troponin T levels ≥0.03 ng/mL within 48 hours after PNL, confirmed by ECG findings if ischemic changes are present.
Surgical Duration
Time from incision to closure (in minutes).
Postoperative Hospital Stay
Duration of hospital stay after surgery (in days).
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Medipol University
Lead sponsor
Istanbul Medipol University Hospital
Collaborator
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