Residual stone area greater in obese patients after conventional percutaneous nephrolithotomy

Abstract

Purpose: To assess the safety and effectiveness of percutaneous nephrolithotomy (PCNL) in patients with obesity.Materials and methods: The records of patients who underwent conventional PCNL were retrospectively evaluated using our database in Department of Urology, Gazi Hospital, Samsun, Turkey, from January 2015 to January 2020. Patients were divided into four groups based on body-mass index (BMI) range <25 (Group 1), 25-29.9 (Group 2), 30-34.9 (Group 3), and ≥35 kg/m2 (Group 4). Baseline characteristics, outcomes, and complications were then compared between the groups. Achieving stone-free status or a residual-stone size of ≤4 mm was regarded as an operational success.Results: A total of 462 patients, 121 (26.2%) in Group 1, 159 (34.4%) in Group 2, 133 (28.8%) in Group 3, and 49 (10.6%) in Group 4, were enrolled in the study. No significant difference was determined in terms of operative time, access number, hemoglobin drop, hospital stay, and success/complication rates. Residual-stone area increased in line with BMI. However, this increase in residual-stone area was only statistically significant in Group 1 and Group 4 (p=0.009). The overall stone clearance rate was 81.8%, and the complication rate requiring invasive procedures was 16.4%.Conclusion: Our study revealed that obesity does not affect the outcomes of PCNL without residual-stone size.