Influence of the body mass index on the outcomes of the percutaneous nephrolithotripsy in patients with large and staghorn stones

Chernyshev I.V., Merinov D.S., Pavlov D.A., Fatihov R.R., Epishov V.A., Artemov A.V.

According to the recommendations of the European and American urological associations percutaneous nephrolithotripsy (PCNL) stands ahead of the other operative modalities in treatment of the patients with large and staghorn stones with the efficacy of approximately 80%. Aim of the current investigation was to estimate the influence of the body mass index (BMI) on the efficacy of the PCNL and on the frequency of the complications during the retrospective analysis of our surgical data.

A comparative analysis was performed in 5 groups of patients (n=217) in regard to the BMI: group I – BMI less than 20 kg/m2, group II – BMI 20-24.9 20 kg/m2, group III – 25-29.9 kg/m2, group IV – 30- 34.9 kg/m2, group V – BMI more than 35 kg/m2. A mean operation time in groups was correspondingly 94.2±29.9, 75.7±26.9, 86.6±28.7, 91.0±32.2 and 87.7±24.3 minutes. A full disintegration and removal of the stone was possible in 69.2, 71.4, 64.3, 54.7 and 66.7% of patients in these groups. An intraoperative bleeding was evident in 12.9% of the total amount of the patients (correspondingly: 10.3, 14.3, 7.1, 15.1 and 38.5% of the patients). The complications of the early postoperative period occurred in 25.8% of all patients and in 18.5, 15.4, 18.6, 32.1 and 35.7% of the patients in the correspondent groups.

According to the analysis, it could be shown, that efficacy of the PCNL is independent of the BMI. Nevertheless, anatomy of the patients with BMI more than 30 kg/m2 could predispose to the intra- and postoperative complications.

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