Safety and efficacy of prone percutaneous nephrolithotomy (PCNL) in morbidly obese patients.

Abstract

Objective: To present our experience regarding the safety and efficacy of prone PCNL in morbidly obese patients. Study Design: Observational study. Setting: Armed Forces Institute of Urology, Rawalpindi. Period: February 2018 to February 2020. Material & Methods: After applying inclusion and exclusion criteria, a total of 47 morbidly obese patients undergoing PCNL in prone position were observed prospectively. The demographic data, intraoperative and postoperative outcomes were evaluated. The data were analyzed by SPSS ver. 24. Results: Average age was (46.43±10.41) years with (70.2%) males and (29.8%) females. The mean basal metabolic index (BMI) is (40.47±3.37) kg/m2 and mean stone size was (2.93±0.49 mm). A single stone is seen in twelve patients (25.5%), multiple in sixteen (34.0 %), partial staghorn in nine (19.1 %) and complete staghorn calculus in ten (21.3%) patients. The mean operative time was (83.38±13.20 min), duration of hospital stay (55.94±16.52 hours), stone-free rate (72.3%) and only (27.7%) patients had re-intervention. Calcium oxalate is the most common stone encountered followed by calcium phosphate and uric acid. Intraoperatively, transfusion secondary to bleeding and postoperatively grade 3 clavien-dindo classification is most commonly seen. Conclusion: Prone PCNL is an effective and safe procedure for morbidly obese patients.