Perkütan nefrolitotomi uygulanan hastalarda obezitenin sonuçlara etkisi: Retrospektif çalışma

The effect of obesity on the outcomes of the patients un- dergoing percutaneous nephrolithotomy: Retrospective study

ALPER ÖTÜNÇTEMUR,Hüseyin BEŞİROĞLU,MURAT DURSUN,Süleyman ŞAHİN,İsmail KÖKLÜ,Mustafa ERKOÇ,Eyyüp DANIŞ,Muammer BOZKURT,Emin ÖZBEK

Özet

Amaç: Kliniğimizde 2003-2013 yılları arasında perkütan The Effect of Obesity on the Outcomes of the Patients Un- nefrolitotomi (PNL) uygulanan hastalarda obezitenin, peri- dergoing Percutaneous Nephrolithotomy: Retrospective operatif veriler ile postoperatif başarı oranı ve komplikas- Study yonlar üzerine etkisi değerlendirildi. Gereç ve Yöntem: Kliniğimizde 2003-2013 yılları arası PNL uygulanan 976 hasta çalışmaya alındı. Hastalar vü- cut kitle indekslerine (VKİ) göre üç gruba ayrıldı. Grup 1 normal ( 0,05). Ortalama analjezik gereksinimi, nefrostomi süresi ve hastanede kalış süresi de tüm gruplar arasında benzerdi (p>0,05). Gruplar arasın- da taşsızlık ve komplikasyon oranları arasında anlamlı bir fark bulunmadı (p>0,05). Sonuç: PNL, obez hastalarda geniş serili çalışmamızda görüldüğü üzere etkinliği yüksek güvenle uygulanabilecek bir yöntemdir.

Abstract

Objective: We evaluated the effect of obesity on periopera- tive findings, postoperative success rate and complications and in the patients under going percutaneous nephrolitho- tomy between 2003-2013. Material and Methods: 976 patients who underwent per- cutaneous nephrolithotomy in our clinic between 2003 and 2013 were included in the study. Patients were divided into three groups according to their body mass index (BMI). They were categorized as Group 1 normal (<25 kg/m2), Group 2 overweight (25-29.9 kg/m2), and Group3 obese (≥30 kg/m2). The impact of BMI was evaluated on pero- perative findings (Access localization, operation time, fluo- roscopy time, bleeding); postoperative outcomes (analgesic requirement, duration of nephrostomy, length of hospital stay), stone-free rates after surgery and complication rates. The outcomes of 976 patients were compared statistically. Results: 568 male and 408 female totally 976 patients with the mean age of 47.6±10 (17-76) underwent PNL. The pro- cedure was performed to the rightside of kidney for 536 pa- tients and left side for 440. 420 (% 43) of the patients were normal-weight, 342 (% 35) of them were over-weighted and 214 (% 22) of them were obese. There was no significant difference between two groups when the rates of supracos- tal access requirement, the average operation time, mean fluoroscopy time and decline in blood count are compared (p>0,05). Average analgesic requirements, duration of hos- pital and nephrostomy stay were similar among all groups (p>0,05). There was no significant difference in stone-free and complication rates between two groups (p>0,05). Conclusion: As seen in our large series study, PNL is a highly effective and safe procedure that can be applied to the obese patients.