Evaluation of Percutaneous Nephrolithotomy (PCNL) in Management of Renal Stones in Adult Patients with Body Mass Index Above Normal Range

Abstract Background Caused obesity and raised body mass index (BMI). People with BMI >25 are at a high risk of cardiovascular problems, tumours, metabolic worse changes and sudden death. In addition, increase of weight and obesity has been demonstrated to raise the risk of renal stone formation. Various research have also concluded that obesity is a major risk factor for anaesthetic and surgical complications like atelectasis, thromboembolic problems, and wound sepsis. Objective To compare and assess the safety, efficacy, outcome, intraoperative, postoperative complications and stone free rates of percutaneous nephrolithotomy (PCNL) in prone position in 4 different groups of adult patients with a body mass index (BMI)<25 and > 25kg/m2. Patients and Methods A prospective, comparative, non-randomized, multicentric cohort study. 60 adult patients with renal stones their sizes are ranging from 2cm to 3cm in diameter will be treated with percutaneous nephrolithotomy in prone position. They will be separated into 4 different groups according to their body mass index (BMI); (Group A) normal body weight patients with BMI 18.5-25 kg/m2, (Group B) overweight patients with BMI 25–29 kg/m2, (Group C) obese patients with BMI 30–39 kg/m2 and (Group D) morbidly obese patientswith BMI ≥40 kg/m2. All of them will be treated in Ain Shams University Hospitals, Dar Alshifa Hospital and El Zaitoun Specialized Hospital in Cairo. Results Regarding Fluoroscopy time, There wasn't a significant difference between the four studied groups (p = 0.907). Regarding Complication, There wasn't a significant difference between the four studied groups (p = 0.886). Regarding Hemoglobin loss, There wasn't a significant difference between the four studied groups (p = 0.677). Regarding Hospital stay, There wasn't a significant difference between the four studied groups (p = 0.804). Conclusion The outcomes of PCNL are not affected by increasing the BMI regarding operative and postoperative complications, as well as operative time, fluoroscopy time and hospital stay. Further comparative studies with larger sample size and longer follow-up are needed to confirm our results and to identify risk factors of adverse events.