Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy
Abstract
Purpose: To assess the safety and effectiveness of percutaneous nephrolithotomy (PCNL) in patients with obesity.
Materials and methods: The records of patients who underwent conventional PCNL were retrospectively evaluated using our database in Department of Urology, Gazi Hospital, Samsun, Turkey, from January 2015 to January 2020. Patients were divided into four groups based on body-mass index (BMI) range <25 (Group 1), 25-29.9 (Group 2), 30-34.9 (Group 3), and ≥35 kg/m2 (Group 4). Baseline characteristics, outcomes, and complications were then compared between the groups. Achieving stone-free status or a residual-stone size of ≤4 mm was regarded as an operational success.
Results: A total of 462 patients, 121 (26.2%) in Group 1, 159 (34.4%) in Group 2, 133 (28.8%) in Group 3, and 49 (10.6%) in Group 4, were enrolled in the study. No significant difference was determined in terms of operative time, access number, hemoglobin drop, hospital stay, and success/complication rates. Residual-stone area increased in line with BMI. However, this increase in residual-stone area was only statistically significant in Group 1 and Group 4 (p=0.009). The overall stone clearance rate was 81.8%, and the complication rate requiring invasive procedures was 16.4%.
Conclusion: Our study revealed that obesity does not affect the outcomes of PCNL without residual-stone size.
Materials and methods: The records of patients who underwent conventional PCNL were retrospectively evaluated using our database in Department of Urology, Gazi Hospital, Samsun, Turkey, from January 2015 to January 2020. Patients were divided into four groups based on body-mass index (BMI) range <25 (Group 1), 25-29.9 (Group 2), 30-34.9 (Group 3), and ≥35 kg/m2 (Group 4). Baseline characteristics, outcomes, and complications were then compared between the groups. Achieving stone-free status or a residual-stone size of ≤4 mm was regarded as an operational success.
Results: A total of 462 patients, 121 (26.2%) in Group 1, 159 (34.4%) in Group 2, 133 (28.8%) in Group 3, and 49 (10.6%) in Group 4, were enrolled in the study. No significant difference was determined in terms of operative time, access number, hemoglobin drop, hospital stay, and success/complication rates. Residual-stone area increased in line with BMI. However, this increase in residual-stone area was only statistically significant in Group 1 and Group 4 (p=0.009). The overall stone clearance rate was 81.8%, and the complication rate requiring invasive procedures was 16.4%.
Conclusion: Our study revealed that obesity does not affect the outcomes of PCNL without residual-stone size.
Keywords
Complication, nephrolithiasis, obesity, percutaneous nephrolithotomy, residual stone
References
- 1. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes. 2008;32:1431–7. doi: 10.1038/ijo.2008.102.
- 2. World Health Organization. Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight; [accessed 10 June 2021].
- 3. Mari A, Abufaraj M, Mansy K, Sievert KD. Obesity and its implications on nononcological urological surgery. Curr Opin Urol. 2017;27(5):456-63. doi: 10.1097/MOU.0000000000000430.
- 4. Türk C, Petřík A, Sarica K, Seits C, Skolarikos A, Straup M, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016;69(3):475–82. doi: 10.1016/j.eururo.2015.07.041.
- 5. Bolat MS, Akdeniz E. Can CROES nephrolithometric nomogram predict postoperative outcomes of percutaneous nephrolithotomy?. New J Urol. 2017;12(2):25-31.
- 6. Zhou X, Sun X, Chen X, Gong X, Yang Y, Chen C, et al. Effect of Obesity on Outcomes of Percutaneous Nephrolithotomy in Renal Stone Management: A Systematic Review and Meta-Analysis. Urol Int. 2017;98(4):382-90. doi: 10.1159/000455162
- 7. Dauw CA, Borofsky MS, York N, Lingeman JE. Percutaneous Nephrolithotomy in the Superobese: A Comparison of Outcomes Based on Body Mass Index. J Endourol. 2016;30(9):987-91. doi: 10.1089/end.2016.0437.
- 8. Isoglu CS, Suelozgen T, Boyacioglu H, Koc G. Effects of body mass index on the outcomes of percutaneous nephrolithotomy. Int Braz J Urol. 2017;43(4):698-703. doi: 10.1590/S1677-5538.IBJU.2016.0678.
- 9. Dede O, Şener NC, Baş O, Dede G, Bağbancı M. Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?. Turk J Urol. 2015;41(1):20-3. doi: 10.5152/tud.2015.94824.
- 10. Torrecilla Ortiz C, Meza Martínez AI, Vicens Morton AJ, Vila Reyes H, Colom Feixas S, Suarez Novo JF, et al. Obesity in percutaneous nephrolithotomy. Is body mass index really important?. Urology. 2014;84(3):538-43. doi: 10.1016/j.urology.2014.03.062.
