The effect of abdominal fat parameters on percutaneous nephrolithotomy success

Abstract

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.

Mini and Standard Percutaneous Nephrolithotomy in Obese Patients. Results from a Single-surgeon Large Series

“…It should, however, be acknowledged that BMI may not be the most relevant anthropometric parameter of obesity for PCNL. A recent single-center study [21] including 150 patients tested the impact of visceral fat and abdominal circumference on PCNL outcome. SFR was not affected by visceral fat area or BMI, but only by abdominal circumference.…”

Clinical Considerations for Patients Experiencing Acute Kidney Injury Following Percutaneous Nephrolithotomy

“…The current literature notes surrogate markers of adverse outcomes in obese patients, such as increased operative times for patients with extreme obesity, longer lengths of stay, and an increase in associated hospital costs [ 39 , 40 , 41 , 42 ]. An interesting and unique analysis from Caymak et al in 2016 found similar results with obesity measured by BMI not having a significant impact on PCNL outcome, but further assessed abdominal circumference (measured via computerized tomography) and found this metric to be of good predictive value for PCNL outcome [ 43 ]. Additionally, surgical positioning in obese patients does not seem to make an impact on AKI and should therefore be decided based on surgeon preference [ 44 ].…”

Skin to calyx distance is not a predictive factor for miniaturized percutaneous nephrolithotomy outcomes

“…In a recent study, Cakmak et al analyzed the effect of abdominal fat parameters on PNL outcomes ( 12 ). In a univariate analysis, they found that visceral fat area (VFA) and abdominal circumference on computerized tomography (ACCT) were predictive factors for estimating PNL success rates.…”