Cakmak Ozgur, Tarhan Huseyin, Cimen Sertac, Ekin Rahmi Gokhan, Akarken Ilker, Oztekin Ozgur, Can Ertan, Suelozgen Tufan, Ilbey Yusuf Ozlem
Tepecik Training and Research Hospital, Urology Department, Izmir, Turkey;
Dalhousie University, Department of Urology, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada;
Can Urol Assoc J. 2016 Mar-Apr;10(3-4):E99-E103. doi: 10.5489/cuaj.3484.
Obesity has been suggested to lower the success of percutaneous nephrolithotomy (PCNL). However, the relationship between abdominal fat parameters, such as visceral and subcutaneous abdominal adipose tissue, and PCNL success remained unclear. In this study, we aimed to investigate the effect of abdominal fat parameters on PCNL success.
A total of 150 patients who underwent PCNL were retrospectively enrolled in this study. Group 1 consisted of patients who had no residual stones or residual stone fragments <3 mm in diameter while group 2 included patients with residual stone fragments ≥3 mm. PCNL procedure was defined as successful if all stones were eliminated or if there were residual stone fragments <3 mm in diameter confirmed by non-contrast computed tomography (NCCT) performed postoperatively. Preoperative NCCT was used to determine abdominal fat parameters.
Group 1 consisted of 117 (78.0%) patients while group 2 included 33 (22.0%) patients. On univariate analysis, stone number, stone surface area (SSA), visceral fat area (VFA), abdominal circumference on computerized tomography (ACCT), and duration of procedure were found to be predictive factors affecting PCNL success. Logistic regression analysis revealed that ACCT and SSA were independent prognostic factors for PCNL success.
PCNL success was not affected by VFA, subcutaneous fat area (SFA) and body mass index (BMI) in our series. However, ACCT and SSA had negative associations with PCNL success. We conclude that both ACCT and SSA can be used as tools for predicting PCNL outcomes.
肥胖被认为会降低经皮肾镜取石术(PCNL)的成功率。然而,腹部脂肪参数,如内脏和皮下腹部脂肪组织,与PCNL成功率之间的关系仍不清楚。在本研究中,我们旨在探讨腹部脂肪参数对PCNL成功率的影响。
本研究回顾性纳入了150例行PCNL的患者。第1组由无残留结石或残留结石碎片直径<3mm的患者组成,而第2组包括残留结石碎片直径≥3mm的患者。如果所有结石均被清除或术后通过非增强计算机断层扫描(NCCT)证实存在直径<3mm的残留结石碎片,则PCNL手术被定义为成功。术前NCCT用于确定腹部脂肪参数。
第1组有117例(78.0%)患者,第2组有33例(22.0%)患者。单因素分析发现,结石数量、结石表面积(SSA)、内脏脂肪面积(VFA)、计算机断层扫描腹部周长(ACCT)和手术时间是影响PCNL成功率的预测因素。逻辑回归分析显示,ACCT和SSA是PCNL成功的独立预后因素。
在我们的系列研究中,PCNL成功率不受VFA、皮下脂肪面积(SFA)和体重指数(BMI)的影响。然而,ACCT和SSA与PCNL成功率呈负相关。我们得出结论,ACCT和SSA均可作为预测PCNL结果的工具。