Percutaneous stone surgery in the obese: outcome stratified according to body mass index

Koo, Brendan; Burtt, Glyn; Burgess, Neil

doi:10.1111/j.1464-410x.2004.04862.x

Cited by 97 publications

(67 citation statements)

References 20 publications

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“…Urologists are now seeing more patients who are morbidly obese for the treatment of renal stones. [12] Morbid obesity is known to be associated with diabetes mellitus (DM), hypertension, respiratory diseases, and many other serious health problems. These patients tend to be at higher risk for complications related to anesthesia during surgery.…”

Section: Discussionmentioning

confidence: 99%

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

Dede¹,

Şener²,

Baş³

et al. 2015

Turkish Journal of Urology

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Objective: The aim of the current study was to investigate whether obesity influences the outcome of extracorporeal shockwave lithotripsy (ESWL) treatment for upper ureteral stones. Material and methods:This is a retrospective study of 134 patients who underwent ESWL between June 2011 and May 2014. Patients were divided into 2 groups. Group 1 comprised 94 patients of normal weight, and group 2 comprised 40 morbidly obese patients. Patients in both groups had upper ureteral stones. Results:The mean age of groups 1 and 2 was 45.6±12.1 and 45.3±15.5 years, respectively (p=0.98). There was no significant difference in demographic variables between the groups. The mean stone size in groups 1 and 2 was 81.7±25.7 mm² and 86.3±22.4 mm², respectively (p= 0.51), the mean body mass index (BMI) was 27.4±2.9 and 42.9±2.1, respectively (p<0.01), the mean number of ESWL sessions was 2.4±0.6 and 2.4±0.7, respectively (p= 0.97), and the mean follow-up time was 7.1±3.4 and 6.6±2.8 weeks, respectively (p= 0.67). The overall stone-free rate was 82% in group 1 and 67% in group 2 (p=0.01). Conclusion:It is well-known that morbidly obese patients have higher rates of anesthesia-related problems due to the comorbidities commonly observed in this population. In the current study, we found that ESWL is a safe and acceptable treatment option for morbidly obese patients with upper ureteral stones.

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Section: Discussionmentioning

confidence: 99%

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

Dede¹,

Şener²,

Baş³

et al. 2015

Turkish Journal of Urology

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“…[7][8][9][10] El-Assmy and colleagues 7 analyzed the outcomes of PCNL in a series of 92 patients at a single high-volume centre with a BMI >40 and found no significant effect on complication rates or stone-related outcomes. There are likely to be multiple factors contributing to the inferior stone-free rate and higher re-treatment rates demonstrated by this study.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11] This study was conceptualized on the basis that obese patients with a BMI in excess of 40 pose unique challenges in terms of intra-operative and postoperative care. To effectively manage such patients, urologists must be able to pre-empt the likely challenges and implement strategies to minimize risk.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] The surgical outcomes related to PCNL in overweight and obese individuals have been investigated, with most studies suggesting that PCNL may be performed with acceptable stone-related outcomes with minimal or no increased risk of major perioperative complications. [7][8][9][10][11] The outcomes of PCNL in patients who are morbidly obese (WHO class III: body mass index [BMI] >40 kg/m 2 ) remain poorly defined. Using prospectively collected data from the multicentre Global PCNL database administered by Clinical Research Office of the Endourological Society (CROES), we review the safety and efficacy of PCNL.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

Fuller

Razvi

Denstedt

et al. 2014

CUAJ

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Background: Efficacy and safety of percutaneous nephrolithotomy (PCNL) have been demonstrated in obese individuals. Yet, there is a paucity of data on the outcomes of PCNL in morbidly obese patients (body mass index [BMI] >40). Methods: Perioperative and stone-related outcomes following PCNL in morbidly obese patients was assessed using a prospective database administered by the Clinical Research Office of the Endourological Society (CROES). A multidimensional match of 97 morbidly obese patients with those of normal weight was created using propensity score matching. Student's t-test and Chi-square tests were used to assess for differences between the groups. Results: In total, 97 patients with a BMI >40 kg/m 2 were matched by stone characteristics with 97 patients of normal weight. The morbidly obese population demonstrated higher rates of diabetes mellitus (43% vs. 6%, p < 0.001) and cardiovascular disease (56% vs. 18%, (p < 0.001). Access was achieved more frequently by radiologists in the morbidly obese group (19% vs. 6%, p = 0.016). Mean operative duration was longer in the morbidly obese group (112 ± 56 min vs. 86 ± 43.5 min, p < 0.001). Stone-free rates were lower in the morbidly obese group (66% vs. 77%, p = 0.071). There was no significant difference in length of hospital stay or transfusion rate. Morbidly obese patients were significantly more likely to experience a postoperative complication (22% vs. 6%, p = 0.004). Interpretation: PCNL in morbidly obese patients is associated with longer operative duration, higher rates of re-intervention and an increased risk of perioperative complications. With this knowledge, urologists should seek to develop strategies to optimize the perioperative management of such patients.

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“…Its incidence is increasing day by day due to inappropriate dietary patterns and decreased physical activities (2). Outcomes of PNL which is frequently performed in stone surgery today are controversial for obese patients There have been some studies reporting that obesity adversely affects the results while some others showed no effect (3,4). We investigated outcomes of PNL in morbid obese patients [body mass index (BMI) ≥40 kg/m 2 ] using the data of our clinic by comparing with a control group.…”

Section: Introductionmentioning

confidence: 99%

Does Morbid Obesity Adversely Affect Success and Complication Rates in Percutaneous Nephrolithotomy?

İşoğlu¹,

Süelözgen²,

Türk³

et al. 2016

jus

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Efficacy of percutaneous nephrolithotomy in morbid obese patients is still debatable. We believe that this study may give valuable information about this topic. ABSTRACTWhat's known on the subject? and What does the study add? ÖZ ObjectiveTo investigate percutaneous nephrolithotomy (PNL) results of morbid obese patients with a body mass index (BMI) of ≥40 kg/m 2 by comparing with a control group of normal BMI (20-25 kg/m 2 ). Materials and MethodsThirty patients with a BMI of ≥40 kg/m 2 were randomly assigned to group 1 and 30 patients with a normal BMI (20-25 kg/m 2 ) constituted group 2 as controls. We compared the groups with regard to baseline characteristics, intraoperative parameters, and stone-free and complication rates. ResultsA total of 60 patients were included in the study. Demographic data and stone burden were similar in both groups. We found no significant differences in access number and success, operative time, and stone-free and complication rates. ConclusionPNL is a safe and effective treatment even for patients with a BMI of ≥40 kg/m 2 . KeywordsKidney, kidney calculi, percutaneous nephrolithotomy, morbid obesity AmaçVücut kitle indeksi (VKİ) 40 kg/m 2 üzerinde olan hastaların perkütan nefrolitotomi (PNL) sonuçlarını VKİ normal sınırlarda olan (20-25 kg/m 2 hastalardan oluşmuş kontrol grubu ile kıyaslamak amaçlandı. Gereç ve YöntemVKİ 40 kg/m 2 üzerinde olan 30 hasta grup 1 olarak adlandırıldı. İstatistiksel olarak uygun kıyaslama yapabilmek için VKİ normal sınırda olan hastalar arasından random olarak 30 hasta seçildi ve grup 2 olarak adlandırıldı. Gruplar temel demografik veriler, intaoperatif parametreler, taşsızlık ve komplikasyon oranları açısından kıyaslandı. BulgularToplam 60 hasta çalışmaya dahil edildi. Demografik veriler ve taş yükü iki grup arasında benzerdi. Gruplar arasında akses sayısı, akses başarısı, operasyon zamanı gibi preoperatif data, taşsızlık ve komplikasyon oranları açısından anlamlı fark saptanmadı. SonuçPNL morbid obez hastalarda bile güvenli ve etkili bir yöntemdir.

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Percutaneous stone surgery in the obese: outcome stratified according to body mass index

Cited by 97 publications

References 20 publications

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?

The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

Does Morbid Obesity Adversely Affect Success and Complication Rates in Percutaneous Nephrolithotomy?

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