Drăguţescu M, Mulţescu R, Geavlete B, Mihai B, Ceban E, Geavlete P
Sf. Ioan Clinical Emergency Hospital, Department of Urology, Bucharest.
J Med Life. 2012 Jun 12;5(2):222-5. Epub 2012 Jun 18.
High-grade obesity raises some specific problems regarding the endourological approach. The aim of our study was to determine if this pathology might influence the outcome of retrograde ureteroscopy.
We evaluated the outcome of 88 ureteroscopies performed in highly obese patients during the last 5 years. The data were compared with the results of 88 consecutive ureteroscopies performed in normal weight patients.
The success rate in the study group was of 91% by comparison with 95% in the normal weight group. The use of flexible ureteroscopes was imposed in 17% of the obese group vs. 11% in the control group. The complications rate (all mild) was of 6.8% in the obese group vs. 4.5% in the normal weight patients. The differences between the two groups, although present, were not statistically significant. However, in two cases with obesity, the weight of the patients was too high for the operating table, imposing supplementary sustaining measures.
Ureteroscopic treatment of stones in obese patients is an acceptable treatment modality, with success rates similar to non-obese patients. Sometimes it may require some logistic measures in the operating theatre.
重度肥胖给腔内泌尿外科治疗带来了一些特殊问题。我们研究的目的是确定这种病理状况是否会影响逆行输尿管镜检查的结果。
我们评估了过去5年中对高度肥胖患者进行的88例输尿管镜检查的结果。将这些数据与对正常体重患者连续进行的88例输尿管镜检查的结果进行比较。
研究组的成功率为91%，而正常体重组为95%。肥胖组中17%的患者需要使用软性输尿管镜，而对照组为11%。肥胖组的并发症发生率（均为轻度）为6.8%，正常体重患者为4.5%。两组之间的差异虽然存在，但无统计学意义。然而，在两例肥胖患者中，患者体重过高，手术台无法承受，需要采取额外的支撑措施。
肥胖患者的输尿管镜结石治疗是一种可接受的治疗方式，成功率与非肥胖患者相似。有时可能需要在手术室采取一些后勤保障措施。
