Stavenga, Jorn Truuske (2025) PCNL in severely obese patients Balancing risk and benefit. thesis, Medicine.
Full text available on request.Abstract
In a time of obesity epidemic, evaluating the safety and efficacy of surgical treatments for obese patients is crucial. Given that obesity is a known risk factor for developing urolithiasis, it is expected that the demand for kidney stone surgeries, particularly percutaneous nephrolithotomy (PCNL), will increase in this population. This study analyzed data from the CAPTURE RCT, using all inclusions (n=217) and found a significantly higher rate of postoperative sepsis requiring ICU admission in cases with a BMI ≥ 35 (10% vs 1.1%). Other demographic and perioperative parameters indicated that both BMI groups had received comparable care, and factors associated with increased infection risk did not explain the found discrepancy, suggesting that a high BMI is an independent risk factor for infectious complications after PCNL. Additionally, cases with BMI ≥ 35 were exposed to higher intraoperative radiation doses, contributing to an undesirable cumulative lifetime radiation burden. Although stone free rates did not differ significantly between BMI categories, cases with a BMI ≥ 35 were less likely to achieve a perceived stone free status intraoperatively. This finding asks for further research into performing PCNL in a novel hybrid operating theatre with opportunity intraoperative CBCT, which has been associated with improved stone clearance in one intervention, but may pose additional risk by prolonging operation duration and is a costly scarce resource that needs well-considered allocation. This study’s findings on the adverse effects of a high BMI on PCNL outcomes supports the role of urologists in advocating for weight reduction strategies, such as referral to combined lifestyle intervention programs (GLI), to improve long-term patient health and improving surgical outcomes.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Roemeling, Dr S. |
| Faculty: | Medical Sciences |
| Date Deposited: | 08 May 2026 13:13 |
| Last Modified: | 08 May 2026 13:13 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3946 |
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