Vücut kitle endeksinin üreteroskopik pnömolitotripsi sonuçlarına etkisi

Amaç: Vücut kitle indeksinin üreteroskopik pnömolitotripsi sonuç ve morbiditesini etkileyip etkilemediğini belirlemek. Gereç ve Yöntemler: Ocak 2006-Nisan 2010 tarihleri arasında, 8 mm ile 15 mm boyutları arasındaki üreter taşı sebebiyle semirigid üreteroskopi (URS) eşliğinde pnömolitotripsi uygulanan 332 hasta çalışmaya dahil edildi.Hastalar vücut kitle endeksine(BMI) göre 4 gruba ayrıldı; Grup 1 (normal), BMI 35 kg/m2. Hastalar preoperatif ve postoperatif düz karın grafisi, renal ultrasonografi, intravenöz piyelografi ve/veya kontrastsız spiral bilgisayarlı tomografi (BT) ile takip edildi. Tedavi edilen hastalarda 0.05). Gruplar arasında taşsızlık oranları, komplikasyon oranları, operasyon süreleri ve hastanede kalış süreleri açısından farklılık izlenmedi. sinin, üreteroskopi etkinliğine ve komplikasyon oranlarına etkisi gözlenmemiştir.

Impact of body mass index on success rates of ureteroscopic pneumolithotripsy

Objective: To determine whether the body mass index (BMI) affects the outcome and mor- bidity of ureteroscopic pneumolitotripsy. Materials and Methods: From January 2006 to April 2010, 332 patients with ureteral stones ranging 8 mm to 15 mm, who under- went semirigid ureteroscopy (URS) with pne- umolithotripsy, were included in the study. Pa- tients were divided into four groups depending on their BMIs: ideal body weight <25 kg/m2 (group 1), overweight 25 to 29.9 kg/m2 (group 2), obese &#8805;30 to 34.9 kg/m2 (group 3) and mor- bidly obese &#8805;35 kg/m2 (group 4). The patients were followed up preoperatively and postoperatively with abdominal plain radiography, renal ultrasonography, intravenous pyelography (IVP) and/or noncontrast spiral computed tomography (CT) . Patients were considered to have been treated successfully if they had <2 mm residual stones. Results: A total of 332 ureteroscopy and pneumolithotripsy were performed on 126 female and 206 male, as a total 332 patients. Of these, 282 (85%) were successfully treated with pneumolithotripsy without residual fragments. There were no significant differences in mean stone sizes, stone lateralizations and stone localizations among four groups. Stone-free rates were 84% in group 1, 89% in group 2, 82% in group 3 and 80% in group 4 (p>0.05). We found no significant differences among groups with regard to stone-free rates, complication rates, operative times and hospital lengths of stay. Conclusions: The results of our study have shown that body mass index had no impact on efficacy or complication rates of ureteroscopy.

Kaynakça

1. Calle EE, Thun MJ, Petrelli JM, et al. Body mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 1999; 341:1097-1105.

2. Andreoni C, Afane J, Olweny E, et al. Flexible ureteroscopic lithotripsy: First line therapy for proximal ureteral and renal calculi in the morbidly obese and superobese patient. J Endourol 2001;15:493-8.

3. Pearle MS, Nakada SY, Womack JS, et al. Outcomes of contemporary percutaneous nephrostolithotomy in morbidly obese patients. J Urol 1998;160:669-73.

4. Goldfarb DS. Increasing prevalence of kidney stones in the United States. Kidney Int 2003;63:1951-2.

5. Curhan GC. Epidemiology of stone disease. Urol Clin North Am 2007;34:287-93.

6. Bagrodia A, Gupta A, Raman JD, et al. Impact of body mass index on cost and clinical outcomes after percutaneous nephrostolithotomy. Urology 2008; 72:756-60.

7. Delakas D, Karyotis I, Daskalopoulos G, et al. Independent predictors of failure of shockwave lithotripsy for ureteral stones employing a second-generation lithotripter. J Endourol 2003;17:201-5.

8. Muñoz RD, Tirolien PP, Belhamou S, et al. Treatment of reno-ureteral lithiasis with ESWL in obese patients. Apropos of 150 patients. Arch Esp Urol 2003; 56: 933-8.

9. El-Nahas AR, El-Tabey NA, Eraky I, et al. Semirigid ureteroscopy for ureteral stones: a multivariate analysis of unfavorable results. J Urol 2009; 181: 1158-62.

10. Aslan Y, Kırılmaz U, Tuncel A, et al. Üreter taşı olan hastalarda rigit üreteroskopi ve pnömotik litotripsi sonuçlarımız. Türk Üroloji Dergisi 2010;36:263-9.

11. Stevens J, Cai J, Pamuk ER, et al. The effect of age on the as- sociation between body-mass index and mortality. N Engl J Med 1998;338: 1-7.

12. Türk C, Knoll T, Petrik A, et al. Guideline on urolithiasis, 2010: 1-106. Available at: http://www.uroweb.org/gls/pdf/ Urolithiasis%202010.pdf

13. Tomaszewski JJ, Smaldone MC, Schuster T, et al. Outcomes of percutaneous nephrolithotomy stratified by body mass index. J Endourol 2010:24:547-50.

14. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA 2005:293:455-62.

15. Duffey BG, Pedro RN, Kriedberg C, et al. Lithogenic risk factors in the morbidly obese population. J Urol 2008;179:1401-6.

16. Calvert RC, Burgess NA. Urolithiasis and obesity: metabolic and technical considerations. Curr Opin Urol 2005;15:113-7.

17. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol 2007;51:899-906.

18. Juan YS, Shen JT, Li CC, et al. Comparison of percutaneous nephrolithotomy and ureteroscopic lithotripsy in the management of impacted, large, proximal ureteral stones. Kaohsiung J Med Sci 2008;24:204-9.

19. Natalin R, Xavier K, Okeke Z, et al. Impact of obesity on ureteroscopic laser lithotripsy of urinary tract calculi. Int Braz J Urol 2009;35:36-42.

20. Faerber GJ, Goh M. Percutaneous nephrolithotripsy in the morbidly obese patient. Tech Urol 1997;3:89-95.

21. Tefekli A, Kurtoglu H, Tepeler K, et al. Does the metabolic syndrome or its components affect the outcome of percutaneous nephrolithotomy? J Endourol 2008;22:35-40.

22. Schuster TG, Hollenbeck BK, Faerber GJ, et al. Complications of ureteroscopy: analysis of predictive factors. J Urol 2001:166:538-40.

23. Johnson DB, Pearle MS. Complications of ureteroscopy. Urol Clin North Am 2004;31:157-71.

24. Best SL, Nakada SY. Flexible ureteroscopy is effective for proximal ureteral stones in both obese and nonobese patients: a two-year, single-surgeon experience. Urology 2011;77:36-9.

Kaynak Göster

Yeni Üroloji Dergisi
  • ISSN: 1305-2489
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2005

862173

Sayıdaki Diğer Makaleler

Should we treat monosymptomatic enuresis in children?

SACİT NURİ GÖRGEL, OSMAN KÖSE, Nida DİNÇEL, Cengiz GİRGİN

Long-term effects of androgen deprivation therapy in prostate cancer patients on metabolic and hematologic parameters

HAŞMET SARICI, Cem Nedim YÜCETÜRK, BERAT CEM ÖZGÜR, Onur TELLİ, Ahmet Metin HASÇİÇEK, TOLGA KARAKAN, Emre HURİ, MUZAFFER EROĞLU

T1 renal kitlelerde açık nefron koruyucu tedavi: Cerrahi, onkolojik ve fonksiyonel sonuçlarımız

Ömer TURANGEZLİ, ŞENOL ADANUR, Tevfik ZİYPAK, HASAN RIZA AYDIN, Turgut YAPANOĞLU, Özkan POLAT

Stress üriner inkontinanslı hastada TVT ameliyatı sonrası mesane içinde taşlaşmış mesh

Buğra Doğukan TÖRER, Abdülmüttalip ŞİMŞEK, Doğukan SÖKMEN, Taner KARGI, Alper BİTKİN, SELÇUK ŞAHİN, Ali İhsan TAŞÇI

Asthenozoospermia: Through the eyes of histology and embryology specialist

ELVAN KOYUN

Eozinofilik sistit olgusu

Erkan ÖlÇÜCÜOĞLU, Ahmet Murat BAYRAKTAR, Sedat TAŞTEMUR, Mehmet Emin ŞİRİN, Öner ODABAŞ, Fatma KAYA ÇEVİK

Unutulan double J stente bağlı gelişen proksimal migrasyon ve hidronefroz: Olgu sunumu ve literatürün gözden geçirilmesi

Sedat YAHŞİ, Ümit ÖZDEMİR, Ömer Gökhan DOLUOĞLU

Vücut kitle endeksinin üreteroskopik pnömolitotripsi sonuçlarına etkisi

Gökhan ATIŞ, Özgür ARIKAN, Eyüp Sabri PELİT, Cengiz ÇANAKCI, Ismail ULUS, Turhan ÇAŞKURLU

Modern tedavi yöntemleriyle metastatik prostat kanserli hastaların seyri değişti mi?

Alper BİTKİN, Ali İhsan TAŞÇI, Erkan SÖNMEZAY, Doğukan SÖKMEN, Abdülmüttalip ŞİMŞEK, Volkan TUĞCU

A rare case report of urothelial carcinoma of the urinary bladder in a 18 years old patient

Onur TELLİ, HAŞMET SARICI, BERAT CEM ÖZGÜR, Mücahit KABAR