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Der Einfluss des Body-Mass-Index auf den Erfolg der Ureterorenoskopie bei Nierensteinen

Effect of the body mass index on outcomes of ureterorenoscopy for renal stones

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Zusammenfassung

Hintergrund

Ziel der vorliegenden Arbeit ist es, die Ureterorenoskopie (URS) hinsichtlich Steinfreiheits- (SFR) und Komplikationsraten (KR) bei Patienten mit Nephrolithiasis und unterschiedlichem Body-Mass-Index (BMI) zu evaluieren.

Material und Methoden

Eine retrospektive Datenanalyse aller Patienten mit bekanntem BMI, die zwischen 2006 und 2012 eine URS wegen Nephrolithiasis in unserer Abteilung erhielten, wurde durchgeführt (n = 556). Die SFR und KR adipöser Patienten wurden mit jenen übergewichtiger und normalgewichtiger Patienten verglichen.

Ergebnisse

Das durchschnittliche Alter betrug 52,51 Jahre und der BMI 27,74 kg/m2. Der ASA-Score unterschied sich zwischen normal- (1,99 ± 0,57), übergewichtigen (2,03 ± 0,62) und adipösen Patienten (2,22 ± 0,63) signifikant (p ≤ 0,036). Die durchschnittliche Steingröße betrug 8,51 ± 6,84 mm und die Steinanzahl/Patient 1,9 ± 2,41 ohne Unterschiede zwischen den Gruppen. Ebenso gab es keine Unterschiede in Bezug auf die präoperative (94,8 %) oder postoperative (60,3 %) Harnleiterschienung, die Verwendung eines Ho:YAG-Lasers (33,6 %), einer flexiblen (16,2 %) oder semirigiden/flexiblen URS (59,4 %) und der Operationsdauer (52,04 ± 34,55 min). Hinsichtlich der SFR bei oberen (90 %), mittleren (94,7 %) und unteren Kelchsteinen (90,2 %), bei multipler Steinlokalisation (68,6 %) und der Gesamt-SFR (86,3 %) waren keine Unterschiede zwischen den Gruppen nachweisbar. Gesamt-SFR von 95,7 %, 88,4 % und 73,7 % wurden bei Nierensteinen < 5 mm, 5–9 mm und ≥ 10 mm Durchmesser gefunden und waren zwischen den Gruppen nicht signifikant verschieden. Die KR lag bei 10,4 % ohne Unterschiede zwischen den Gruppen.

Schlussfolgerungen

Die URS ist ein geeignetes Verfahren zur Behandlung von Nierensteinen mit hohen SFR und niedrigen KR unabhängig des BMI des Patienten.

Abstract

Background

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.

Materials and methods

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.

Results

Mean age was 52.51 years and the average BMI 27.74 kg/m2. Of the patients, 34.2 % had normal weight (22.59 ± 1.91 kg/m2), 39.6 % were overweight (27.30 ± 1.42 kg/m2), and 26.3 % were obese (35.09 ± 5.93 kg/m2). 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).

Conclusion

URS is an appropriate treatment for renal stones with high SFR and low CR regardless of patient’s BMI.

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Authors and Affiliations

  1. Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland

    F. Schott, S. Knipper, A. K. Orywal, A. J. Gross & C. Netsch

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  1. F. Schott
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  2. S. Knipper
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  3. A. K. Orywal
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Correspondence to F. Schott.

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Interessenkonflikt

F. Schott, S. Knipper, A. K. Orywal, A. J. Gross und C. Netsch geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Schott, F., Knipper, S., Orywal, A.K. et al. Der Einfluss des Body-Mass-Index auf den Erfolg der Ureterorenoskopie bei Nierensteinen. Urologe 55, 1462–1469 (2016). https://doi.org/10.1007/s00120-016-0132-3

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  • DOI: https://doi.org/10.1007/s00120-016-0132-3

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