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.
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