Does body mass index effect the success of percutaneous nephrolithotomy?

Şimşek, Abdülmuttalip; Özgör, Faruk; Akbulut, Mehmet; Küçüktopçu, Onur; Berberoğlu, Ahmet Yalçın; Sarılar, Ömer; Binbay, Murat; Müslümanoğlu, Ahmet Yaser

doi:10.5152/tud.2014.66674

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…Additionally, body mass index does not affect success rates or the frequency of complications post-PCNLl. 21 In present study, ileus (without need NG tube), fever and transient hematuria were almost similarly encountered among the three groups (Clavien grade 1 complications). Interestingly, transfusion rates were not dissimilar among these groups (see Table-III ) and statistically the difference was insignificant (p=0.73).…”

Section: Discussionsupporting

confidence: 66%

Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience

Iqbal

Hasan²,

Razzaq³

et al. 2022

Pak J Med Sci

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Background and Objectives: Urolithiasis is prevalent globally. Over time, innovation in endoscopic instruments and miniaturization has untangled the interventional strategy for carrying out remedial surgical procedures for renal stones. However, studies have been scarce as for sequelae of Percutaneous Nephrolithotomy (PCNL) in varying body mass index group patients in the developing world. We aimed to report success rates and complications in different BMI groups. Methods: This was a retrospective study wherein data of 359 patients was reviewed in charts. These patients went through PCNL at our department from July 2011 till September 2019. Three groups of patients were made in agreement with WHO BMI classification. Information concerning study variables was noted in designated and then processed in SPSS version 16 for the statistical computations. Results: On the whole, the mean age of patients was 44.6± 14.4 years. While the mean calculus size was 3.1± 1.4 cm. Moreover, the majority of stones in all the three groups belonged to Guy’s stone score 1 and 2 (see Table-I). The overall mean procedure time and inpatient stay were almost comparable in the obese group. The highest stone-free rate was observed in the normal weight group (77.69 %), however, stone-free status in overweight and obese groups was not comparatively too lower (p=0.74). Complication rates were being close among the three groups. Conclusion: PCNL can be ventured with safety and in an effectual manner for attaining stone treatment goals alike in obese and non-obese group patients. doi: https://doi.org/10.12669/pjms.38.8.3663 How to cite this:Iqbal N, Hasan A, Razzaq S, Rashid FS. Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.3663 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 66%

Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience

Iqbal

Hasan²,

Razzaq³

et al. 2022

Pak J Med Sci

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“…In a study done by Şimşek et al, patients who underwent PNL in the prone position were divided into 4 groups according to BMI: normal body weight (BMI <25 kg/m2), overweight (BMI 25-29.9 kg/m2), obese (BMI 30-39 kg/m2) and morbidly obese (BMI >40 kg/m2). It was reported that there was no significant difference related to the complication rates between all groups (10). Additionally, in the study conducted by Ferreira et al, it was indicated for obese and non-obese patients who had PNL performed that no considerable difference was identified in terms of overall complication rates (13.8% and 13.6%, respectively, as Clavien grade ≥1) and major complication rates (8.4% and 5%, respectively as Clavien grade ≥3) (13).…”

Section: Discussionmentioning

confidence: 90%

“…Studies demonstrate that concerning treating nephrolithiasis in obese patients, both prone PNL and supine PNL are safe techniques with high effectiveness and emphasize that the complication rates for individuals with obesity are similar to those of the general population (10,13). In a study done by Şimşek et al, patients who underwent PNL in the prone position were divided into 4 groups according to BMI: normal body weight (BMI <25 kg/m2), overweight (BMI 25-29.9 kg/m2), obese (BMI 30-39 kg/m2) and morbidly obese (BMI >40 kg/m2).…”

Section: Discussionmentioning

confidence: 99%

“…On review of the current literature concerning PNL in patients with obesity, most of the studies were designed to compare the results of obese and non-obese participants in the same position (supine or prone) (10)(11)(12)(13). For a more objective evaluation of nephrolithiasis in obese patients, some authors highlighted the need to contrast the advantages and disadvantages of these two positions within the same study (8).…”

Section: Discussionmentioning

confidence: 99%

“…As a result of the associated comorbidities in obese individuals, it is suggested that PNL, apart from the standard prone position, may be performed more reliably in the supine position due to the cardiopulmonary advantages it provides (9). Examining the current literature regarding PNL for obese patients, most studies have been designed to contrast the results of obese and non-obese patients in the same position (supine or prone) (10)(11)(12)(13). In this study, for only adults with obesity, we compare prone and supine PNL, which are frequently applied at our clinic, in terms of efficacy and safety.…”

Section: Introductionmentioning

confidence: 99%

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Supine versus prone percutaneous nephrolithotomy: A comparison of efficacy and safety in obese patients

et al. 2022

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Objective: To compare prone and supine percutaneous nephrolithotomy (PNL) in obese patients with respect to efficacy and safety.Material and Methods: Individuals with kidney stones larger than 2 cm undergoing either prone or supine position PNL were included in the study based on the World Health Organization (WHO) classification of body mass index (BMI) ≥30 kg/m2 between January 2011 and September 2020 retrospectively. Demographic characteristics, intraoperative, postoperative data, and complications according to Modified Clavien Grading System were listed. Patients were followed for 3 months, documenting their stone-free status. Results: Out of the total 156 obese patients, 74(47.4%) underwent supine PNL (group 1), and 82 (52.6%) were prone to PNL (group 2). There was no statistically significant difference between the groups concerning hemoglobin drop, the number of pelvicalyceal access, blood transfusion, length of hospital stay, complications rates, and stone-free status (p>0.05). The location of pelvicalyceal access (upper, middle, lower calyces) was significantly different (18.9%, 32.4%, 42.6% in group 1, 3.2%, 19.3%, 77.5% in group 2, respectively) (p<0.001). Mean operative times were statistically different between the groups (97.2 ± 18.1 minutes in group 1, 119.5 ± 18.9 minutes in group 2, respectively) (p<0.001).Conclusion: In the prone or supine position, PNL is a safe and effective method for managing kidney stones in obese patients. Access through the upper calyx may be favored in the supine position considering to patient’s characteristics. Additionally, the supine position has the greatest advantage over the prone position due to shorter operative times.

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Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study

Perez,

Neeman,

Dotan

et al. 2023

Urolithiasis

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Percutaneous nephrolithotomy (PCNL) is considered gold standard treatment of renal stones larger than 20mm. Several studies have shown that ultrasound guidance during this procedure is more effective and safer than uoroscopy. A higher body mass index (BMI) can make ultrasound-guided renal access more di cult and unsuccessful. We present a prospective analysis and comparison of ultrasound-guided PCNL in patients with normal and increased body mass index.We performed a prospective comparison of patients who underwent ultrasound-guided PCNL to remove renal stones by a single surgeon between 2020 and 2022. Patients with BMIs greater than 30 (mean 33.87-Obese) were compared to those with BMIs less than 30 (mean 25.69-non-Obese). Demographic, perioperative, and follow-up data were collected, analyzed, and included in this study.Total of 98 consecutive patients, with 49 patients in each group. No statistically signi cant differences were observed in terms of stone volume (p = 0.085), stone density (P = 0.5590), location of renal access (P = 0.108), surgery duration (P = 0.38), blood loss (P = 0.54), or laboratory changes after surgery (P = 0.60). 87.76% of obese patients were stone-free per CT scan at follow-up, compared to 73.47% of normalweight patients (P = 0.1238). According to Clavien Dindo classi cation, six patients in the non-obese group experienced grade II (10%) and grade III (2%) complications, as opposed to six patients in the obese group with grade I (2%), grade II (6%), and grade III (2%) complications.There was no signi cant correlation between body mass index and the success or safety of ultrasoundguided PCNL. Although more challenging, a higher BMI should not be an impediment to performing this approach. This method is safe, with no increased incidence of postoperative complications or compromise in stone-free status post-operatively and can diminish or avoid both patient's and medical team's exposure to ionizing radiation.

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Does body mass index effect the success of percutaneous nephrolithotomy?

Cited by 10 publications

References 27 publications

Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience

Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience

Supine versus prone percutaneous nephrolithotomy: A comparison of efficacy and safety in obese patients

Ultrasound-guided percutaneous nephrolithotomy (PCNL) success rates in patients with elevated body mass index: a comparative study

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