Effect of Obesity on Outcomes of Percutaneous Nephrolithotomy in Renal Stone Management: A Systematic Review and Meta-Analysis

Zhou, Xiangjun; Sun, Xiaofeng; Chen, Xuhua; Gong, Xiaohua; Yang, Yong; Chen, Congbo; Yao, Qingqing

doi:10.1159/000455162

Cited by 38 publications

(39 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, BMI was associated with increased blood transfusion rate. These findings agree with Zhou X et al [20] who demonstrated that PCNL in obese and morbidly obese patients yields a stone-free rate that is comparable to that achieved in nonobese one. Contrary to our finding, Ş imşek A et al [21] reported that BMI does not affect the blood transfusion rate in PCNL.…”

Section: Discussionsupporting

confidence: 92%

Factors Affecting Safety and Efficacy of PCNL in Lower Calyceal Stones

El-Sakka¹,

El-Gamal

2018

The Medical Journal of Cairo University

View full text Add to dashboard Cite

Background: The management of lower calyceal stones is still one of today's topics in endourology. Percutaneous nephrolithotomy (PCNL) is found to be a highly effective procedure in treatment of lower pole calculi. However, many factors are affecting the stone free rate and complication rate. Aim of the Study:The aim of this study was to evaluate the factors that affect the safety and efficacy of PCNL in lower calyceal stones more than 2cm.Patients and Methods: Forty eight patients with lower pole calculi more than 2 cm underwent percutaneous nephrolithotomy. Preoperative, operative and postoperative data were reported. Multivariate analyses as well as univariate analyses were used to investigate the effects of different variables on residual stones and blood transfusion rate. These factors include age, sex, laterality, body mass index, history of ipsilateral open renal surgery, operative time, lower pole parenchymal thickness, presence of hydronephrosis, stone burden and stone density.Results: Unvariate analysis determined that stone burden (p<0.001), stone count (p<0.02), lower pole parenchymal thickness (p<0.03), presence of hydronephrosis ( p<0.001) and operative time (p<0.04) were statistically significant with the stone free rate. Multivariate analysis revealed that, presence of hydronephrosis (odds ratio [OR]: 0.365, 95% confidence interval [CI]: 0.104-0.652, p=0.034), lower pole parenchymal thickness (OR: 0.347, 95% CI: 0.241-0.874, p=0.04), the operative time (OR: 0.587, 95% CI: 0.149-0.857, p=0.032), stone count (OR: 0.647, 95% CI: 0.205-0.874, p=0.028) and stone burden (OR: 0.428, 95% CI: 0.169-0.985, p=0.021) were significant independent factors influence stone residual. Univariate analysis determined that stone burden ( p<0.001), body mass index (p<0.015), history of ipsilateral open renal surgery (p<0.017), lower pole parenchymal thickness (p<0.001) and operative time (p<0.015) correlated with blood transfusion rate. Multivariate analysis revealed that stone burden (OR: 0.628, 95% CI: 0.149-0.852, p=0.014), operative time (OR: 0.452, 95% CI: 0.125-0.856, p=0.002), lower pole parenchymal thickness (OR: 0.365, 95% CI: 0.014-0.836, p=0.002), body mass index (OR: 0.589, 95% CI: 0.159-0.744, p=0.038) and history of ipsilateral surgery (OR: 0.635, 95% CI: 0.258-0.825, p=0.017) were significant independent factors influence blood transfusion rate.Conclusion: PCNL is a safe and effective procedure for lower calyceal stones more than 2cm. The stone free rate in the study was affected mainly by the stone burden and the operative time, the stone count, the degree of hydronephrosis and the lower pole parenchymal thickness were also involved. The blood transfusion rate was also affected by the stone burden, the operative time, the BMI, history of ipsilateral open renal surgery and the lower pole parenchymal thickness.

show abstract

Section: Discussionsupporting

confidence: 92%

Factors Affecting Safety and Efficacy of PCNL in Lower Calyceal Stones

El-Sakka¹,

El-Gamal

2018

The Medical Journal of Cairo University

View full text Add to dashboard Cite

show abstract

“…Nevertheless, the use of F-URS in obese patients presents challenges including long-term stone discharge, increased overall cost and requirement of multiple interventions (Sari et al, 2013). However, traditional PCNL has been proven to be a safe and effective alternative in obese patients (Trudeau et al, 2016;Zhou et al, 2017). When compared with conventional PCNL, super-mini percutaneous nephrolithotomy (SMP) causes less blood loss and fewer perioperative complications (Zeng et al, 2016;Liu et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

A retrospective study comparing super-mini percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of 20–30 mm renal stones in obese patients

Song

et al. 2020

PeerJ

View full text Add to dashboard Cite

Objective This study aimed to compare the efficacy and safety of Super-mini percutaneous nephrolithotomy (SMP) and flexible ureteroscopy (F-URS) in the treatment of 20–30 mm renal stones in obese patients. Methods We conducted a retrospective analysis of outcomes of patients who underwent SMP and F-URS to treat 20–30 mm renal stones from August 2017 to September 2018. Patients with BMI >30 kg/m2 were enrolled into this study. Forty-eight patients underwent SMP, while 104 patients underwent F-URS by the same surgeon. The patients’ demographic data, stone characteristics, perioperative parameters and outcomes, complications, stone-free rate (SFR) and overall costs were retrospectively assessed. Results No significant differences were found between the two groups in terms of age, gender, BMI, operation side, stone size, number, locations, stone compositions and CT value. The mean operation time was significantly shorter in the SMP group (p < 0.001), while the F-URS group had significantly shorter postoperative stays (p < 0.001) and lower complication rates (p < 0.001). Both groups had similar SFR at a 3-month follow-up (p = 0.190), while the SMP group achieved significant higher SFR 3 days after the operation (p < 0.001). The SMP group had a significantly lower overall cost and fewer stage-2 procedures than the F-URS group. Conclusion SMP and F-URS are equally effective in obese patients with 20–30 mm renal stones. However, F-URS offers the advantage of a lower complication rate, while SMP performed better in terms of operation time, tubeless rate, stage-2 procedures and overall costs.

show abstract

“…Nevertheless, the use of F-URS in obese patients presents challenges including long-term stone discharge, increased overall cost and requirement of multiple interventions [7]. However, traditional PCNL has been proven to be a safe and effective alternative in obese patients [8][9]. When compared with conventional PCNL, super-mini percutaneous nephrolithotomy (SMP) causes less blood loss and fewer perioperative complications [10][11].…”

Section: Introductionmentioning

confidence: 99%

Peer Review #1 of "A retrospective study comparing super-mini percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of 20–30 mm renal stones in obese patients (v0.2)"

2020

View full text Add to dashboard Cite

This study aimed to compare the efficacy and safety of Super-mini percutaneous nephrolithotomy (SMP) and flexible ureteroscopy (F-URS) in the treatment of 20-30 mm renal stones in obese patients. Methods: We conducted a retrospective analysis of outcomes of patients who underwent SMP and FURS to treat 20-30 mm renal stones from August 2017 to September 2018. Patients with BMI > 30 kg/m 2 were enrolled into this study. 48 patients underwent SMP, while 104 patients underwent FURS by the same surgeon. The patients' demographic data, stone characteristics, perioperative parameters and outcomes, complications, stone-free rate (SFR) and overall costs were retrospectively assessed. Results: No significant differences were found between the two groups in terms of age, gender, BMI, operation side, stone size, number, locations, stone compositions and CT value. The mean operation time was significantly shorter in the SMP group (p < 0.001), while the FURS group had significantly shorter postoperative stays (p < 0.001) and lower complication rates (p < 0.001). Both groups had similar SFR at a 3 month follow-up (p = 0.190), while the SMP group achieved significant higher SFR 3 days after the operation (p < 0.001). The SMP group had a significantly lower overall cost and fewer stage-2 procedures than the FURS group. Conclusion: SMP and FURS are equally effective in obese patients with 20-30 mm renal stones. However, FURS offers the advantage of a lower complication rate, while SMP performed better in terms of operation time, tubeless rate, stage-2 procedures and overall costs.

show abstract

Effect of Obesity on Outcomes of Percutaneous Nephrolithotomy in Renal Stone Management: A Systematic Review and Meta-Analysis

Cited by 38 publications

References 29 publications

Factors Affecting Safety and Efficacy of PCNL in Lower Calyceal Stones

Factors Affecting Safety and Efficacy of PCNL in Lower Calyceal Stones

A retrospective study comparing super-mini percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of 20–30 mm renal stones in obese patients

Peer Review #1 of "A retrospective study comparing super-mini percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of 20–30 mm renal stones in obese patients (v0.2)"

Contact Info

Product

Resources

About