The CROES Percutaneous Nephrolithotomy Global Study: The Influence of Body Mass Index on Outcome

Fuller, Andrew; Razvi, Hassan; Denstedt, John D.; Nott, Linda; Pearle, Margaret S.; Cauda, F; Bolton, Damien; Celia, Antonio; Rosette, Jean de la

doi:10.1016/j.juro.2012.03.013

Cited by 106 publications

(104 citation statements)

References 27 publications

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“…Obese patients should be provided with accurate and indi- vidualized information regarding the risks and likely outcomes of PCNL. This article adds to our previous report 11 considering outcomes of PCNL stratified by BMI. In particular, the matched comparison of morbidly obese patients with those of healthy weight provides useful insight, particularly regarding the significantly increased risk of postoperative complications, in the morbidly obese group.…”

Section: Discussionmentioning

confidence: 82%

“…[7][8][9][10][11] This study was conceptualized on the basis that obese patients with a BMI in excess of 40 pose unique challenges in terms of intra-operative and postoperative care. To effectively manage such patients, urologists must be able to pre-empt the likely challenges and implement strategies to minimize risk.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] The surgical outcomes related to PCNL in overweight and obese individuals have been investigated, with most studies suggesting that PCNL may be performed with acceptable stone-related outcomes with minimal or no increased risk of major perioperative complications. [7][8][9][10][11] The outcomes of PCNL in patients who are morbidly obese (WHO class III: body mass index [BMI] >40 kg/m 2 ) remain poorly defined. Using prospectively collected data from the multicentre Global PCNL database administered by Clinical Research Office of the Endourological Society (CROES), we review the safety and efficacy of PCNL.…”

Section: Introductionmentioning

confidence: 99%

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The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

Fuller

Razvi

Denstedt

et al. 2014

CUAJ

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Background: Efficacy and safety of percutaneous nephrolithotomy (PCNL) have been demonstrated in obese individuals. Yet, there is a paucity of data on the outcomes of PCNL in morbidly obese patients (body mass index [BMI] >40). Methods: Perioperative and stone-related outcomes following PCNL in morbidly obese patients was assessed using a prospective database administered by the Clinical Research Office of the Endourological Society (CROES). A multidimensional match of 97 morbidly obese patients with those of normal weight was created using propensity score matching. Student's t-test and Chi-square tests were used to assess for differences between the groups. Results: In total, 97 patients with a BMI >40 kg/m 2 were matched by stone characteristics with 97 patients of normal weight. The morbidly obese population demonstrated higher rates of diabetes mellitus (43% vs. 6%, p < 0.001) and cardiovascular disease (56% vs. 18%, (p < 0.001). Access was achieved more frequently by radiologists in the morbidly obese group (19% vs. 6%, p = 0.016). Mean operative duration was longer in the morbidly obese group (112 ± 56 min vs. 86 ± 43.5 min, p < 0.001). Stone-free rates were lower in the morbidly obese group (66% vs. 77%, p = 0.071). There was no significant difference in length of hospital stay or transfusion rate. Morbidly obese patients were significantly more likely to experience a postoperative complication (22% vs. 6%, p = 0.004). Interpretation: PCNL in morbidly obese patients is associated with longer operative duration, higher rates of re-intervention and an increased risk of perioperative complications. With this knowledge, urologists should seek to develop strategies to optimize the perioperative management of such patients.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

Fuller

Razvi

Denstedt

et al. 2014

CUAJ

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“…The Clinical Research Office of the Endourological Sovciety study group published the first prospective study including 3.709 patients (17). PNL-operated patients were sorted with respect to their BMI.…”

Section: Discussionmentioning

confidence: 99%

Does Morbid Obesity Adversely Affect Success and Complication Rates in Percutaneous Nephrolithotomy?

İşoğlu¹,

Süelözgen²,

Türk³

et al. 2016

jus

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Efficacy of percutaneous nephrolithotomy in morbid obese patients is still debatable. We believe that this study may give valuable information about this topic. ABSTRACTWhat's known on the subject? and What does the study add? ÖZ ObjectiveTo investigate percutaneous nephrolithotomy (PNL) results of morbid obese patients with a body mass index (BMI) of ≥40 kg/m 2 by comparing with a control group of normal BMI (20-25 kg/m 2 ). Materials and MethodsThirty patients with a BMI of ≥40 kg/m 2 were randomly assigned to group 1 and 30 patients with a normal BMI (20-25 kg/m 2 ) constituted group 2 as controls. We compared the groups with regard to baseline characteristics, intraoperative parameters, and stone-free and complication rates. ResultsA total of 60 patients were included in the study. Demographic data and stone burden were similar in both groups. We found no significant differences in access number and success, operative time, and stone-free and complication rates. ConclusionPNL is a safe and effective treatment even for patients with a BMI of ≥40 kg/m 2 . KeywordsKidney, kidney calculi, percutaneous nephrolithotomy, morbid obesity AmaçVücut kitle indeksi (VKİ) 40 kg/m 2 üzerinde olan hastaların perkütan nefrolitotomi (PNL) sonuçlarını VKİ normal sınırlarda olan (20-25 kg/m 2 hastalardan oluşmuş kontrol grubu ile kıyaslamak amaçlandı. Gereç ve YöntemVKİ 40 kg/m 2 üzerinde olan 30 hasta grup 1 olarak adlandırıldı. İstatistiksel olarak uygun kıyaslama yapabilmek için VKİ normal sınırda olan hastalar arasından random olarak 30 hasta seçildi ve grup 2 olarak adlandırıldı. Gruplar temel demografik veriler, intaoperatif parametreler, taşsızlık ve komplikasyon oranları açısından kıyaslandı. BulgularToplam 60 hasta çalışmaya dahil edildi. Demografik veriler ve taş yükü iki grup arasında benzerdi. Gruplar arasında akses sayısı, akses başarısı, operasyon zamanı gibi preoperatif data, taşsızlık ve komplikasyon oranları açısından anlamlı fark saptanmadı. SonuçPNL morbid obez hastalarda bile güvenli ve etkili bir yöntemdir.

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“…10 Although the potential impact of obesity on PCNL success has been investigated, the influence of different abdominal adipose tissue compartments and abdominal fat parameters on PCNL outcomes remained unclear. 11,12 In the present study, we aimed to investigate the effect of abdominal fat parameters and stone characteristics on PCNL success.…”

Section: Introductionmentioning

confidence: 99%

The effect of abdominal fat parameters on percutaneous nephrolithotomy success

Çakmak

Tarhan

Çimen

et al. 2016

CUAJ

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Introduction: Obesity has been suggested to lower the success of percutaneous nephrolithotomy (PCNL). However, the relationship between abdominal fat parameters, such as visceral and subcutaneous abdominal adipose tissue, and PCNL success remained unclear. In this study, we aimed to investigate the effect of abdominal fat parameters on PCNL success. Methods: A total of 150 patients who underwent PCNL were retrospectively enrolled in this study. Group 1 consisted of patients who had no residual stones or residual stone fragments <3 mm in diameter while group 2 included patients with residual stone fragments ≥3 mm. PCNL procedure was defined as successful if all stones were eliminated or if there were residual stone fragments <3 mm in diameter confirmed by non-contrast computed tomography (NCCT) performed postoperatively. Preoperative NCCT was used to determine abdominal fat parameters. Results: Group 1 consisted of 117 (78.0%) patients while group 2 included 33 (22.0%) patients. On univariate analysis, stone number, stone surface area (SSA), visceral fat area (VFA), abdominal circumference on computerized tomography (ACCT), and duration of procedure were found to be predictive factors affecting PCNL success. Logistic regression analysis revealed that ACCT and SSA were independent prognostic factors for PCNL success. Conclusions: PCNL success was not affected by VFA, subcutaneous fat area (SFA) and body mass index (BMI) in our series. However, ACCT and SSA had negative associations with PCNL success. We conclude that both ACCT and SSA can be used as tools for predicting PCNL outcomes.

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The CROES Percutaneous Nephrolithotomy Global Study: The Influence of Body Mass Index on Outcome

Abstract: Percutaneous nephrolithotomy may be done safely in obese patients, although with a longer operative time, an inferior stone-free rate and a higher re-intervention rate.

Cited by 106 publications

References 27 publications

The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

Does Morbid Obesity Adversely Affect Success and Complication Rates in Percutaneous Nephrolithotomy?

The effect of abdominal fat parameters on percutaneous nephrolithotomy success

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