Percutaneous Nephrolithotomy in Obese Patients, Is There Any Challenge?
- 1 Department of Surgery, School of Medicine, University of Sulaimani, Sulaimani, Iraq
- 2 Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Iraq
Abstract
Percutaneous nephrolithotomy (PNL) is a safe and effective procedure in the treatment of large renal stones in obese and non-obese patients with low rate of morbidity and high success rate in different groups of body mass index (BMI), some surgeons believe that morbid obesity increases the risk of complications of PNL, but different recent studies showed there were no significant differences. Objective: To analyze the outcomes of PNL in patients with different BMI and to assess the effects of obesity in the result of PNL in terms of efficacy & safety regarding total operative time, blood transfusion, organ injury, stone clearance, hospital stay, and the need of auxiliary procedures. Patients and methods: This is a prospective study on patients with different body mass indexes need PNL. Age above 18 years with no co-morbidity had been included in this study from Jan 2015-Oct 2016 in governmental & two private hospitals in Sulaimania, after application of exclusion and inclusion criteria. All patients had a questioner’s paper to agree on participation in this study. Patients were classified into 3 groups according to the World Health Organization (WHO) classification of body mass index (BMI). Standard PNL with ideal instruments had been used. Intra operative and post-operative findings recorded in Excel data sheet. The patients were followed for one month. The outcomes in these 3 groups were compared. Results & analysis of the data: A total 117 patients had PNL. There was no any statistically significant difference between different BMI groups intra operatively & post operatively in this study with ( P value < 0.05) regarding stone clearance, operative time, hospital stay, organ injury, Hemoglobin drop, post-operative renal impairment, and post-operative fever. Conclusion: PNL operation is a relatively safe & efficacious treatment for patients having renal stone with different BMI range from normal to obese patients without significant challenge.
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