TAIPEI, TAIWAN (UroToday.com) - Obesity is a risk factor for many adverse events in patients undergoing abdominal and urologic surgical procedures. In addition, it is a known risk factor for recurrent nephrolithiasis. Percutaneous nephrolithotomy (PCNL) has previously been shown to be safe in the obese (BMI 30–34.9), and severely obese (BMI 35–39.9); however, there is limited evidence supporting its use in morbidly (BMI 40–44.9) or super obese patients with the BMI of 45 and above.
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Dr. Necole Streeper’s group from the University of Wisconsin performed a retrospective review of 67 cases with a BMI of 40 who underwent PCNL. Patients were divided into different groups according to their BMI of 40–49.9, 50–59.9, and > 60, and outcomes were compared. The variables evaluated included operative time, length of hospital stay, stone burden, complication rate, and stone-free rate. Stone burden was measured on preoperative CT scans.
Baseline stone volume was similar among all groups. The overall stone-free rate after a single procedure was 72%, with a complication rate of 10%, which is lower than that reported in the literature. No statistically significant differences were revealed across all BMI subgroups with respect to length of hospital stay, complications, and stone-free rate.
The authors concluded that the BMI > 60 does not impact the PCNL outcomes. The complication rate, length of hospital stay, or stone-free rate is equal in all patients. There may be a relationship between BMI and adjunct procedures to achieve comparable stone-free status.
Presented by Necole M. Streeper, Andrew C. Radtke, Kristina L. Penniston, and Stephen Y. Nakada at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
University of Wisconsin School of Medicine and Public Health, Madison, WI USA
Written by Zhamshid Okhunov, MD, Department of Urology, School of Medicine, University of California-Irvine, and medical writer for UroToday.com