Parenchymal Thickness: Does It Have an Impact on Outcomes of Percutaneous Nephrolithotomy?

Abstract

Objective: To evaluate whether renal parenchymal thickness (RPT) has an effect on the outcomes of percutaneous nephrolithotomy (PNL). Methods: We performed a retrospective analysis of 144 patients with lower pole and/or renal pelvic stones who underwent PNL. The relationship between RPT and peri- and postoperative measures was evaluated. Results: The average age was 45.94 ± 14.47 (15-76) years. The mean BMI was calculated as 27.47 ± 4.73 (16.9-44.9) kg/m². The mean stone burden was 293 ± 126 (150-800 mm²). The mean RPT was measured as 17.33 ± 5.32 (6-35) mm. No correlation was detected between the RPT and the operation or fluoroscopy times or the duration of hospitalization (p = 0.63, 0.52, 0.08, respectively). The mean drop in hemoglobin level was 1.45 ± 1.25 (0-9) g/dl. A negative correlation was detected between hemoglobin drop and RPT (p = 0.01, r = -0.23). However, the RPT was similar in patients who did or did not require a blood transfusion (p = 0.09). The RPT was found to have no impact on success rate (p = 0.4). Conclusion: The postoperative hemoglobin drop increases in parallel with the increase in RPT. However, no relationship was detected between the RPT and blood transfusion, overall success rate or any other perioperative parameters.

Skin-to-Stone Distance Has No Impact on Outcomes of Percutaneous Nephrolithotomy

“…Similar findings were shown in a study with a smaller patient number done by Sergeyev et al [16]. In their study where the effect of renal parenchymal thickness on PCNL was evaluated, Tepeler et al [7] found that with the increase in renal parenchymal thickness, the decrease in hemoglobin increased but the blood transfusion rate remained unchanged. Wang et al [22] also demonstrated that a thick renal parenchyma without hydronephrosis was a risk factor for severe bleeding after PCNL.…”

“…It was supported by other studies with smaller patient numbers [16,17 ]that obesity does not have an influence on stone-free rates after PCNL. In another study assessing the effects of renal parenchymal thickness on PCNL outcomes, no relationship between renal parenchymal thickness and the success of operation was found [7]. In our study, patients were evaluated by being grouped according to SSD, which is influenced by obesity and renal parenchymal thickness.…”

“…SSD increases due to localization of the stone, increase in subcutaneous and visceral adipose tissue, and thickness of the renal parenchyma. An increase in renal parenchymal thickness does not have an impact on the efficiency and safety of PCNL [7]. In this study, the effect of SSD on the success and safety of PCNL was studied.…”

“…Carson et al [19] also reported that obesity did not affect operation and hospitalization times. Tepeler et al [7] showed that there was no correlation between renal parenchymal thickness and operation, fluoroscopy and hospitalization times. In our study, hospitalization, fluoroscopy and operation times were longer in patients with shorter SSD than in those with longer SSD, but there was no statistical significance.…”

“…The association between renal parenchymal thickness and the efficacy and safety of PCNL has been studied by Tepeler et al [7]. Studies evaluating the effect of SSD on the success of ESWL have demonstrated that increased SSD lowers the stone-free rates after ESWL [8,9,10].…”