EYÜP VELİ KÜÇÜK, Berkan ŞİMŞEK, Ahmet BİNDAYI, Ahmet TAHRA, Uğur BOYLU

Morbid obez hastalarda perkütan nefrolitotomi

indeksi VKİ >35 kg/m2 perkütan nefrolitotomi PNL operasyonun etkinliğinin ve güvenilirliğin değerlendirilmesi ve normal kilolu VKİ = 18.5-25 kg/m2 hastalarla operasyonun sonuçlarının karşılaştırılması. Materyal ve Metod: Morbid obez ve normal kilolu hastalarda PNL operasyonun preoperatif, peroperatif ve postoperatif sonuçları retrospektif olarak değerlendirildi. 32 morbid obez ve 112 normal kilolu hasta değerlendirmeye alındı. Sonuçlar: Normal kilolu hasta grubunda yaş ortalaması 45.3 iken, morbid obez grubunda 42.6 idi. Morbid obez hasta grubunda diabetes mellitus %70.5 ile %7.1, p 0.05 . Yorum: Morbid obez hastalarda perkütan nefrolitotomi etkin ve güvenilir bir tedavi yöntemidir

Anahtar Kelimeler:

Obezite, böbrek taşı, perkütan nefrolitotomi

Percutaneous nephrolitotomy in morbidly obese patients

Purpose: To evaluate the efficacy and safety of percutaneous nephrolithotomy PCNL in morbidly obese Body mass index BMI >35 kg/ m2 patients and compare the outcomes of the operation with normal weighted BMI = 18.5 – 25 kg/m2 patients. Material and Methods: We evaluated the perioperative and stone-related outcomes following PCNL in morbidly obese and normal weighted patients retrospectively. 32 morbidly obese and 112 normal weighted patients enrolled into this study. Results: Mean ages of normal weighted and morbidly obese patients were 45.3 and 42.6, respectively. The morbidly obese patients demonstrated higher rates of diabetes mellitus 70.5% vs. 7.1%, p 0.05 . There was no significant difference in the transfusion rate and the length of hospital stay. There was no statistically significant difference between complication rates in two groups 9.8% vs. 8.8%, p >0.05 . Comment: Percutaneous nephrolitotomy is safe and effective procedure in morbidly obese patients.

Keywords:

Obesity, kidney stone, percutaneous nephrolitotomy,

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Alyami FA, Skinner TA, Norman RW. Impact of body mass index on clinical outcomes associated with percutaneous nephrolithotomy. Can Urol Assoc J 2013;7:197-201.
Satman I, Yumuk VD, Erem C et al. Türk endokrinoloji ve metabolizma derneği(TEMD)- Obezite, Dislipidemi, Hi- pertansiyon Çalışma Grubu, Obezite Kılavuzu Hazırlama ve Düzenleme Komitesi, Obezite Tanı ve Tedavi Kılavuzu 2015.
Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA 2003;289:187- 93.
Thomas R, Cass AS. Extracorporeal shock wave lithotripsy in morbidly obese patients, J Urol. 1993;150:30-2.
Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up, J Am Soc Nephrol 2004;15:3225-32.
Fernström I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique, .Scand J Urol Nephrol 1976;10:257-9.
Nasraway SA Jr, Albert M, Donnelly AM, Ruthazer R, Shikora SA, Saltzman E. Morbid obesity is an independent determinant of death among surgical critically ill patients, Crit Care Med 2006;34:964-70.
Calvert RC, Burgess NA. Urolithiasis and obesity: metabolic and technical considerations, Curr Opin Urol 2005;15:113-7.
Taylor EN, Curhan GC. Body size and 24-hour urine composition. Am J Kidney Dis 2006;48:905-15.
Daudon M, Lacour B, Jungers P. Influence of body size on urinary stone composition in men and women. Urol Res 2006;34:193-9.
Bensalah K, Raman JD, Bagrodia A, Marvin A, Lotan Y. Does obesity impact the costs of partial and radical nephrectomy?. J Urol 2008;179:1714-7.
Carson CC III, Danneberger JE, Weinerth JL. Percutaneous lithotripsy in morbid obesity. J Urol 1988;139:243-5.
El-Assmy AM, Shokeir AA, El-Nahas AR et al. Outcome of percutaneous nephrolithotomy: effect of body mass index. Eur Urol 2007;52:199-204.
Koo BC, Burtt G, Burgess NA. Percutaneous stone surgery in the obese: outcome stratified according to body mass index. BJU Int 2004;93:1296-9.
Chang SS, Duong DT, Wells N, Cole EE, Smith JA Jr, Cookson MS. Predicting blood loss and transfusion requirements during radical prostatectomy: the significant negative impact of increasing body mass index. J Urol 2004;171:1861-5.
Fuller A, Razvi H, Denstedt JD et al. (CROES PCNL Study Group). The CROES percutaneous nephrolithotomy global study: the influence of body mass index on outcome. J Urol 2012;188:138-44.
Oberg B, Poulsen TD. Obesity: an anaesthetic challenge, Acta Anaesthesiol Scand 1996;40:191-200.
Brodsky JB, Oldroyd M, Winfield HN, Kozlowski PM. Morbid obesity and the prone position: a case report. J Clin Anesth 2001;13:138-40.
Shoma AM, Eraky I, El-Kenawy MR, El-Kappany HA. Percutaneous nephrolithotomy in the supine position: technical aspects and functional outcome compared with the prone technique. Urology 2002;60:388-92.
Kanaroglou A, Razvi H. Percutaneous nephrolithotomy under conscious sedation in morbidly obese patients. Can J Urol 2006;13:3153-5.
El-Husseiny T, Moraitis K, Maan Z et al. Percutaneous endourologic procedures in high-risk patients in the lateral decubitus position under regional anesthesia, J Endourol 2009;23:1603-6.