Safety and efficacy of percutaneous nephrolithotomy in obese patients

Objective: In this study, we investigated the the effects of obesity on peroperatif findings, postoperative results, postoperative complication rates and morbidity in patients treated with percutaneous nephrolithotomy (PNL).

Materials and methods: The data of 194 patients who underwent PNL were analyzed. Patients were divided into three groups depending body mass index (BMI); Group 1: normal weight (<25 kg/m2), Group 2: overweight (25-29.9 kg/m2), Group 3: obese (≥30 kg/m2). The impact of BMI on operative findings (access localization, operation duration, fluoroscopy duration, hemorrhage), postoperative outcomes (analgesic requirement, nephrostomy duration, hospital stay), stone-free status, and complication rates were evaluated using univariate analysis.

Results: Of the patients, 79 (40.7%) were normal weight, 70 (36.1%) overweight, and 45 (23.2%) were obese. Mean stone burden was 475±525 mm3, 376±266 mm3, and 387±275 mm3 in normal weight, overweight, and obese patients, respectively (p=0.27). No significant differences among three groups were found with respect to supracostal access necessity (13%, 18% and 18%), operation duration (112 min, 110 min and 110 min), floroscopy duration (10 min, 11 min and 12 min), and postoperative hemoglobin drop rate (12.3%, 12.8% and 12.9%). Mean analgesic requirement, nephrostomy duration, hospitalization duration were also similar between all groups. There was no significant difference between groups in terms of the stone-free rates (75.9%, 72.1%, and 80%) and complication rates (9%, 7.4%, and 13.3%).

Conclusion: Since peroperative findings, postoperative results, and postoperative stone-free rates were similar in normal weight, overweight, and obese patients; PNL appears to be a safe and effective procedure in obese patients.