Evaluation of the Impact of Body Mass Index on the Outcomes of Supine Percutaneous Nephrolithotomy

Yıl 2024, , 121 - 128, 30.10.2024

Ender Cem Bulut , Burak Elmas , Bora Küpeli

https://doi.org/10.33719/nju1534944

Öz

Objective: This study aimed to evaluate the impact of obesity on the outcomes of supine percutaneous nephrolithotomy (PCNL) in a tertiary care center. Understanding surgical outcomes in obese patients, given their rising prevalence and urolithiasis risk, is crucial for optimizing treatment strategies.
Materials and Methods: This retrospective study included data from 256 patients aged 18 and older who underwent PCNL in the Galdakao-Valdivia position between July 2021 and July 2024 at a tertiary care hospital. Patients were categorized into three groups based on their body mass index (BMI): normal weight (BMI: 18-24.9 kg/m²), overweight (BMI: 25-29.9 kg/m²), and obese (BMI: 30-34.9 kg/m²). Demographic data, stone characteristics, operative time, fluoroscopy time, hospital stay, nephrostomy duration, stone-free rates (SFR), and complications were analyzed and compared across the three groups.
Results: There was no significant difference between the groups regarding age, sex, stone laterality, location, or size (p>0.05). Median BMI values were significantly different between the groups (p<0.001). The stone-free rates were 79.2%, 77%, and 75% for the normal, overweight, and obese groups, respectively (p>0.05). No significant differences were found in operative time, fluoroscopy time, hospital stay, or nephrostomy time among the groups (p>0.05). Minor and major complication rates were similar across all groups (p>0.05).
Conclusion: Obesity does not appear to significantly impact the outcomes of supine PCNL, including operative time, stone-free rates, or complication rates. These findings suggest that with experienced surgeons, supine PCNL is a safe and effective treatment option for obese patients, though further prospective studies are needed to confirm these results.

Anahtar Kelimeler

supine percutaneous nephrolithotomy, kidney stone, obesity, body mass index

Etik Beyan

This study was reviewed and approved by the Ethics Committee of Gazi University on 30 July 2024 (approval number 1268).

Vücut Kitle İndeksinin Supin Perkütan Nefrolitotomi Sonuçları Üzerindeki Etkisinin Değerlendirilmesi

Öz

Özet
Amaç: Bu çalışma, obezitenin üçüncü basamak bir sağlık merkezinde supin perkütan nefrolitotomi (PCNL) sonuçları üzerindeki etkisini değerlendirmeyi amaçlamaktadır. Obez hastalardaki cerrahi sonuçların anlaşılması, artan prevalansları ve ürolitiyazis riski göz önüne alındığında, tedavi stratejilerinin optimize edilmesi için kritik öneme sahiptir.
Materyal-Metot: Bu retrospektif çalışma, Temmuz 2021 ile Temmuz 2024 tarihleri arasında üçüncü basamak bir hastanede Galdakao-Valdivia pozisyonunda PCNL uygulanan 18 yaş ve üzeri 256 hastanın verilerini içermektedir. Hastalar, beden kitle indeksine (BMI) göre normal kilolu (BMI: 18-24.9 kg/m²), aşırı kilolu (BMI: 25-29.9 kg/m²) ve obez (BMI: 30-34.9 kg/m²) olmak üzere üç gruba ayrıldı. Demografik veriler, taş özellikleri, ameliyat süresi, floroskopi süresi, hastanede kalış süresi, nefrostomi süresi, taşsızlık oranları (SFR) ve komplikasyonlar gruplar arasında analiz edilerek karşılaştırıldı.
Bulgular: Gruplar arasında yaş, cinsiyet, taş tarafı, yeri veya boyutu açısından anlamlı bir fark bulunmadı (p>0.05). Gruplar arasında median BMI değerleri açısından anlamlı bir fark vardı (p<0.001). Taşsızlık oranları sırasıyla normal kilolu, aşırı kilolu ve obez gruplarda %79.2, %77 ve %75 olarak bulundu (p>0.05). Operasyon süresi, floroskopi süresi, hastanede kalış süresi veya nefrostomi süresi açısından gruplar arasında anlamlı bir fark bulunmadı (p>0.05). Minör ve majör komplikasyon oranları tüm gruplarda benzerdi (p>0.05).
Sonuç: Obezitenin, supin PCNL sonuçları üzerinde operasyon süresi, taşsızlık oranları veya komplikasyon oranları gibi faktörler açısından önemli bir etkisi olmadığı görülmektedir. Bu bulgular, deneyimli cerrahlar tarafından gerçekleştirildiğinde, supin PCNL'nin obez hastalar için güvenli ve etkili bir tedavi seçeneği olduğunu düşündürmektedir. Ancak, bu sonuçların doğrulanması için daha geniş hasta popülasyonları ile yapılacak prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

supin perkütan nefrolitotomi, böbrek taşı, obezite, vücut kitle indeksi

Etik Beyan

Bu çalışma Gazi Üniversitesi Etik Kurulu tarafından 30 Temmuz 2024 tarihinde incelenerek onaylanmıştır (onay numarası: 1268).

Kaynakça

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