Obez hastalarda perkütan nefrolitotomi sonrası rezidü taş alanı daha büyüktür

Abstract

Amaç: Obez hastalarda perkütan nefrolitotominin (PNL) güvenliğini ve etkinliğini değerlendirmektir.
Gereç ve yöntem: Ocak 2015-Ocak 2020 tarihleri arasında Samsun Gazi Hastanesi, Üroloji Kliniği’nde konvansiyonel PNL yapılan hastaların kayıtları retrospektif olarak veri tabanımız kullanılarak değerlendirildi. Hastalar vücut kitle indeksi (VKİ) kullanılarak <25 (Grup 1), 25-29,9 (Grup 2), 30-34,9 (Grup 3) ve ≥35 kg/m2 (Grup 4) olmak üzere dört gruba ayrıldı. Hastaların klinik özellikleri, operasyon bilgileri ve komplikasyonları değerlendirildi. Taşsızlık veya ≤4 mm küçük taş boyutu operasyonel başarı olarak kabul edildi.
Bulgular: Grup 1'de 121 (%26,2), Grup 2'de 159 (%34,4), Grup 3'te 133 (%28,8) ve Grup 4'te 49 (%10,6) olmak üzere toplam 462 hasta çalışmaya alındı. Ameliyat süresi, akses sayısı, hemoglobin düşüşü, hastanede kalış süresi ve başarı/komplikasyon oranları açısından gruplar arasında anlamlı bir fark saptanmadı. VKİ ile uyumlu olarak rezidü taş alanının arttığı görüldü. Ancak bu artış sadece Grup 1 ve Grup 4 arasında anlamlıydı (p=0,009). Başarı oranımız %81,8 ve invaziv işlem gerektiren komplikasyon oranımız %16,4’dü.
Sonuç: Çalışmamızda obezitenin rezidü taş dışında PCNL’nin sonuçlarına etkisi olmadığı bulunmuştur.

Keywords

• Komplikasyon
• böbrek taşı
• obezite
• perkütan nefrolitotomi
• rezidü taş

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.

Keywords

• Complication
• nephrolithiasis
• obesity
• percutaneous nephrolithotomy
• residual stone

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