MP23-03 ULTRASOUND-GUIDED PERCUTANEOUS NEPHROLITHOTOMY (PCNL) SUCCESS RATES IN PATIENTS WITH ELEVATED BODY MASS INDEX, A COMPARATIVE STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP23-03 ULTRASOUND-GUIDED PERCUTANEOUS NEPHROLITHOTOMY (PCNL) SUCCESS RATES IN PATIENTS WITH ELEVATED BODY MASS INDEX, A COMPARATIVE STUDY Dolev Perez, David Dotan, Binyamin Neeman, Boris Chertin, and Ilan Kafka Dolev PerezDolev Perez More articles by this author , David DotanDavid Dotan More articles by this author , Binyamin NeemanBinyamin Neeman More articles by this author , Boris ChertinBoris Chertin More articles by this author , and Ilan KafkaIlan Kafka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003248.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Percutaneous nephrolithotomy (PCNL) is considered the gold standard for the treatment of renal stones larger than 20 mm. Several studies have shown that ultrasound guidance during this procedure is more effective and safer than fluoroscopy. A higher body mass index (BMI) can make ultrasound- guided renal access more difficult and unsuccessful. We present a retrospective analysis and comparison of ultrasound- guided PCNL in patients with normal and increased body mass index. METHODS: We performed a retrospective comparison of patients who underwent ultrasound- guided PCNL to remove renal stones by a single surgeon between 2020 and 2022. Patients with BMIs greater than 30 (mean 33.87-Obese) were compared to those with BMIs less than 30 (mean 25.69-non-Obese). Demographic, preoperative, and follow- up data were collected, analyzed, and included in this study. RESULTS: The study included a total of 98 consecutive patients, with 49 patients in each group. No statistically significant differences were observed in terms of stone volume (p=0.085), stone density (p=0.5590), location of renal access (p=0.108), surgery duration (p=0.38), blood loss (p=0.54), or laboratory changes after surgery (p=0.60). 91.84 precent of obese patients were stone- free per CT scan at follow- up, compared to 77.5 percent of normal- weight patients (p=0.089). According to Clavien Dindo classification, six patients in the non-obese group experienced grade II (10%) and grade III (2%) complications, as opposed to five patients in the obese group with grade I (2%), grade II (6%), and grade III (2%) complications. CONCLUSIONS: There was no significant correlation between body mass index and the or safety of ultrasound- guided PCNL. Although more challenging, a higher BMI should not be an impediment to performing this approach. This method is safe, with no increased incidence of postoperative complications or compromise in stone- free status post- operatively, and can diminish or even avoid both patient's and medical team's exposure to ionizing radiation. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e306 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dolev Perez More articles by this author David Dotan More articles by this author Binyamin Neeman More articles by this author Boris Chertin More articles by this author Ilan Kafka More articles by this author Expand All Advertisement PDF downloadLoading ...