Araştırma Makalesi
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Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy

Yıl 2022, Cilt 15, Sayı 3, 563 - 569, 01.07.2022
https://doi.org/10.31362/patd.1090404

Öz

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.

Kaynakça

  • 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.
  • 11. El-Assmy AM, Shokeir AA, El-Nahas AR, Shoma AM, Eraky I, El-Kenawy MR, et al. Outcome of percutaneous nephrolithotomy: effect of body mass index. Eur Urol. 2007;52:199–204. doi: 10.1016/j.eururo.2006.11.049.
  • 12. Fuller A, Razvi H, Denstedt JD, Nott L, Hendrix A, Luke M, Pal SK, Rosette J. The clinical research office of the endourological society percutaneous nephrolithotomy global study: outcomes in the morbidly obese patient-a case control analysis. Can Urol Assoc J. 2014;8:393-7. doi: 10.5489/cuaj.2258.
  • 13. Parkin L, Sweetland S, Balkwill A, Green J, Reeves G, Beral V; Million Women Study Collaborators. Body mass index, surgery, and risk of venous thromboembolism in middle-aged women: a cohort study. Circulation. 2012;125(15):1897-904. doi: 10.1161/CIRCULATIONAHA.111.063354.
  • 14. Nowfar S, Palazzi-Churas K, Chang DC, Sur RL. The relationship of obesity and gender prevalence changes in United States inpatient nephrolithiasis. Urology. 2011;78(5):1029–33. doi: 10.1016/j.urology.2011.04.011.
  • 15. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA. 2005;293:455–62. doi: 10.1001/jama.293.4.455.
  • 16. Sarica K. Obesity and stones. Curr Opin Urol. 2019;29(1):27‐32. doi: 10.1097/MOU.0000000000000557.
  • 17. Mosli HA, MosliHH. Increased body mass index is associated with larger renal calculi. Urology. 2012;80:974–79. doi: 10.1016/j.urology.2012.07.027.
  • 18. Ferreira TAC, Dutra MMG, Vicentini FC, Szwarc M, Mota PKV, Eisner B, et al. Impact of Obesity on Outcomes of Supine Percutaneous Nephrolithotomy. J Endourol. 2020;34(12):1219-1222. doi: 10.1089/end.2020.0576.

Obez hastalarda perkütan nefrolitotomi sonrası rezidü taş alanı daha büyüktür

Yıl 2022, Cilt 15, Sayı 3, 563 - 569, 01.07.2022
https://doi.org/10.31362/patd.1090404

Öz

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.

Kaynakça

  • 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.
  • 11. El-Assmy AM, Shokeir AA, El-Nahas AR, Shoma AM, Eraky I, El-Kenawy MR, et al. Outcome of percutaneous nephrolithotomy: effect of body mass index. Eur Urol. 2007;52:199–204. doi: 10.1016/j.eururo.2006.11.049.
  • 12. Fuller A, Razvi H, Denstedt JD, Nott L, Hendrix A, Luke M, Pal SK, Rosette J. The clinical research office of the endourological society percutaneous nephrolithotomy global study: outcomes in the morbidly obese patient-a case control analysis. Can Urol Assoc J. 2014;8:393-7. doi: 10.5489/cuaj.2258.
  • 13. Parkin L, Sweetland S, Balkwill A, Green J, Reeves G, Beral V; Million Women Study Collaborators. Body mass index, surgery, and risk of venous thromboembolism in middle-aged women: a cohort study. Circulation. 2012;125(15):1897-904. doi: 10.1161/CIRCULATIONAHA.111.063354.
  • 14. Nowfar S, Palazzi-Churas K, Chang DC, Sur RL. The relationship of obesity and gender prevalence changes in United States inpatient nephrolithiasis. Urology. 2011;78(5):1029–33. doi: 10.1016/j.urology.2011.04.011.
  • 15. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA. 2005;293:455–62. doi: 10.1001/jama.293.4.455.
  • 16. Sarica K. Obesity and stones. Curr Opin Urol. 2019;29(1):27‐32. doi: 10.1097/MOU.0000000000000557.
  • 17. Mosli HA, MosliHH. Increased body mass index is associated with larger renal calculi. Urology. 2012;80:974–79. doi: 10.1016/j.urology.2012.07.027.
  • 18. Ferreira TAC, Dutra MMG, Vicentini FC, Szwarc M, Mota PKV, Eisner B, et al. Impact of Obesity on Outcomes of Supine Percutaneous Nephrolithotomy. J Endourol. 2020;34(12):1219-1222. doi: 10.1089/end.2020.0576.

Ayrıntılar

Birincil Dil İngilizce
Konular Üroloji ve Nefroloji
Yayınlanma Tarihi Temmuz 2022
Bölüm Araştırma Makalesi
Yazarlar

Kemal ÖZTÜRK> (Sorumlu Yazar)
Department of Urology, Gazi Hospital
0000-0001-7555-4209
Türkiye


Metin GUR>
Department of Urology, Gazi Hospital
0000-0002-4130-1630
Türkiye


Muhammet Bahaettin ULU>
Department of Urology, Gazi Hospital
0000-0002-1894-9316
Türkiye


Süleyman Tümer ÇALIŞKAN>
Department of Urology, Gazi Hospital
0000-0001-8940-2476
Türkiye


Ekrem AKDENİZ>
Department of Urology, Samsun Training and Research Hospital
0000-0002-0666-9579
Türkiye

Yayımlanma Tarihi 1 Temmuz 2022
Kabul Tarihi 31 Mayıs 2022
Yayınlandığı Sayı Yıl 2022, Cilt 15, Sayı 3

Kaynak Göster

Bibtex @araştırma makalesi { patd1090404, journal = {Pamukkale Tıp Dergisi}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2022}, volume = {15}, number = {3}, pages = {563 - 569}, doi = {10.31362/patd.1090404}, title = {Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy}, key = {cite}, author = {Öztürk, Kemal and Gur, Metin and Ulu, Muhammet Bahaettin and Çalışkan, Süleyman Tümer and Akdeniz, Ekrem} }
APA Öztürk, K. , Gur, M. , Ulu, M. B. , Çalışkan, S. T. & Akdeniz, E. (2022). Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy . Pamukkale Tıp Dergisi , 15 (3) , 563-569 . DOI: 10.31362/patd.1090404
MLA Öztürk, K. , Gur, M. , Ulu, M. B. , Çalışkan, S. T. , Akdeniz, E. "Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy" . Pamukkale Tıp Dergisi 15 (2022 ): 563-569 <https://dergipark.org.tr/tr/pub/patd/issue/68347/1090404>
Chicago Öztürk, K. , Gur, M. , Ulu, M. B. , Çalışkan, S. T. , Akdeniz, E. "Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy". Pamukkale Tıp Dergisi 15 (2022 ): 563-569
RIS TY - JOUR T1 - Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy AU - Kemal Öztürk , Metin Gur , Muhammet Bahaettin Ulu , Süleyman Tümer Çalışkan , Ekrem Akdeniz Y1 - 2022 PY - 2022 N1 - doi: 10.31362/patd.1090404 DO - 10.31362/patd.1090404 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 563 EP - 569 VL - 15 IS - 3 SN - -1308-0865 M3 - doi: 10.31362/patd.1090404 UR - https://doi.org/10.31362/patd.1090404 Y2 - 2022 ER -
EndNote %0 Pamukkale Tıp Dergisi Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy %A Kemal Öztürk , Metin Gur , Muhammet Bahaettin Ulu , Süleyman Tümer Çalışkan , Ekrem Akdeniz %T Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy %D 2022 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 15 %N 3 %R doi: 10.31362/patd.1090404 %U 10.31362/patd.1090404
ISNAD Öztürk, Kemal , Gur, Metin , Ulu, Muhammet Bahaettin , Çalışkan, Süleyman Tümer , Akdeniz, Ekrem . "Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy". Pamukkale Tıp Dergisi 15 / 3 (Temmuz 2022): 563-569 . https://doi.org/10.31362/patd.1090404
AMA Öztürk K. , Gur M. , Ulu M. B. , Çalışkan S. T. , Akdeniz E. Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy. Pam Tıp Derg. 2022; 15(3): 563-569.
Vancouver Öztürk K. , Gur M. , Ulu M. B. , Çalışkan S. T. , Akdeniz E. Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy. Pamukkale Tıp Dergisi. 2022; 15(3): 563-569.
IEEE K. Öztürk , M. Gur , M. B. Ulu , S. T. Çalışkan ve E. Akdeniz , "Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy", Pamukkale Tıp Dergisi, c. 15, sayı. 3, ss. 563-569, Tem. 2022, doi:10.31362/patd.1090404
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