體重指數對於經皮腎造廔截石手術在手術成果上所扮演的角色
陳採風、李苑如1、陳忠信1
天主教耕莘醫院新店總院 外科部 泌尿科；國立台灣大學附設醫院 泌尿部1
THE ROLE of body mass index PREDICTING outcome of percutaneous nephrolithotripsy
Tsai-Feng Chen, Yuan-Ju Lee, Chung-Hsin Chen
Division of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City, Taiwan
University, Taipei, Taiwan. Department of Urology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan1
Purpose: To evaluate the impact of body mass index (BMI) on clinical outcomes and safety profiles of percutaneous nephrolithotripsy (PCNL).
Materials and Methods: We retrospectively reviewed the patients who received percutaneous nephrolithotripsy (PCNL) between January 2015 and December 2016. A total of 184 consecutive patients were enrolled. The patients were categorized into 3 groups according to BMI (normal: BMI ≤ 24, overweight: 24 < BMI ≤ 27, obesity: BMI > 27). The stone clearance rate, operation time, duration of hospital stay, post-operative analgesic use and post-operation complications were compared among groups. The categorical variable was analyzed by Chi square test, and the continuous variable was analyzed by Kruskal-wallis test. The possible prognosticators for stone clearance were also analyzed using logistic regression method.
Results: There were no significant differences among groups in terms of age, gender, stone character, stone size, and laterality. A higher proportion of hypertension were observed in the larger BMI groups, and lower hemoglobin level in the smaller BMI group. No significant differences of stone clearance rate (66%, 76%, 70% in normal size, overweight and obesity groups, respectively), duration of hospital stay, post-operative analgesic use, and complication rate were identified among groups. The most common complication was post-operative fever in all groups. Multivariable analysis showed the stone character was a significant prognosticator for stone clearance.
Conclusion: BMI did not reveal impact on the stone clearance, operative time, duration of hospital stay, postoperative analgesic requirement, and postoperative complication in patients undergoing PCNL.