Schott F, Knipper S, Orywal A K, Gross A J, Netsch C
Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
Urologe A. 2016 Nov;55(11):1462-1469. doi: 10.1007/s00120-016-0132-3.
Purpose of this work is to compare the outcome of ureterorenoscopy (URS) with regard to stone-free rates (SFR) and complication rates (CR) in patients with different body mass index (BMI) scores for the treatment of kidney stones.
A retrospective chart review of all patients with known BMI, who underwent URS for kidney stones between 2006 and 2012 at our institution, was performed (n = 556 patients). The SFR and CR of obese patients were compared to overweight and normal weight patients.
Mean age was 52.51 years and the average BMI 27.74 kg/m. Of the patients, 34.2 % had normal weight (22.59 ± 1.91 kg/m), 39.6 % were overweight (27.30 ± 1.42 kg/m), and 26.3 % were obese (35.09 ± 5.93 kg/m). The mean ASA score differed significantly between normal weight (1.99 ± 0.57), overweight (2.03 ± 0.62), and obese (2.22 ± 0.63) patients (p ≤ 0.036). The mean stone size was 8.51 ± 6.84 mm and the mean number of stones per patient 1.9 ± 2.41, whereby the differences between groups was not significant. There were no differences between the groups regarding the use of preoperative (94.8 %) and postoperative ureteral stents (60.3 %), the Ho:YAG laser (33.6 %), the use of flexible (16.2 %) or semirigid/flexible URS (59.4 %), and the mean operative time (52.04 ± 34.55 min). There were no differences in the SFR for the upper (90 %), mid (94.7 %), and lower pole (90.2 %), multiple location (68.6 %) or the total SFR (86.3 %). Total SFR of 95.7, 88.4, and 73.7 % for urinary calculi < 5 mm, 5-9 mm, and ≥ 10 mm, respectively, were found and the differences between the patient groups was not significant. The CR was 10.4 % (differences between the patient groups not significant).
URS is an appropriate treatment for renal stones with high SFR and low CR regardless of patient's BMI.
本研究旨在比较不同体重指数（BMI）评分的肾结石患者接受输尿管肾镜检查（URS）后的结石清除率（SFR）和并发症发生率（CR）。
对2006年至2012年在我院接受URS治疗肾结石且已知BMI的所有患者进行回顾性病历审查（n = 556例患者）。将肥胖患者的SFR和CR与超重和正常体重患者进行比较。
平均年龄为52.51岁，平均BMI为27.74kg/m²。患者中，34.2%体重正常（22.59±1.91kg/m²），39.6%超重（27.30±1.42kg/m²），26.3%肥胖（35.09±5.93kg/m²）。正常体重（1.99±0.57）、超重（2.03±0.62）和肥胖（2.22±0.63）患者的平均美国麻醉医师协会（ASA）评分差异有统计学意义（p≤0.036）。平均结石大小为8.51±6.84mm，每位患者的平均结石数量为1.9±2.41，各组之间差异无统计学意义。在术前（94.8%）和术后输尿管支架的使用（60.3%）、钬:钇铝石榴石（Ho:YAG）激光（33.6%）、软性（16.2%）或半硬性/软性URS的使用（59.4%）以及平均手术时间（52.04± 34.55分钟）方面，各组之间无差异。上极（90%）、中极（94.7%）和下极（90.2%）、多部位（ 68.6%）或总SFR（86.3%）的SFR无差异。分别发现<5mm、5 - 9mm和≥10mm尿结石患者的总SFR为95.7%、88.4%和73.7%，患者组之间差异无统计学意义。CR为10.4%（患者组之间差异无统计学意义）。
无论患者BMI如何，URS都是治疗肾结石的一种合适方法，具有高SFR和低CR。
