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DOI :10.26650/IUITFD.2021.839546   IUP :10.26650/IUITFD.2021.839546    Full Text (PDF)

DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?

Ahmed Ömer Halat, Muhammet İrfan Dönmez, Murat Gönen, Ömer Erkam Arslan, Betül Başaran

Objective: The primary aim of this study is to evaluate if severe obesity has any deleterious effect on the early postoperative course in patients undergoing percutaneous nephrolithotomy (PNL) under spinal anesthesia, and the secondary aim is to determine whether severe obesity changes surgical results. Material and Method: The study included 100 patients who underwent a PNL operation for kidney stones of ≥2cm in our clinic. Accordingly, those with BMI <35 kg/m2 formed the first while the severely obese BMI ≥35 kg/m2 formed the second group. Age, gender, stone burden, pre/postoperative hemoglobin levels, number and regions of access, duration of surgery, perioperative complications and Visual Analogue Scale score at 24h, PACU admission/ discharge Aldrete scores, and PACU length of stay were recorded. Results: The VAS score was 5.0±1.3 in group 1 while it was 5.3±1.8 in group 2 (p=0.32). The length of the hospital stay was 3.3±1.3 days in patients with BMI <35 kg/m2 and 3.0±1.0 in patients with BMI ≥35 kg/m2 (p=0.36). A 98% stone-free rate was found in the severely obese group and 96% in the normal BMI group, and there was no significant difference between the groups (p=0.672). There was a statistically significant difference in terms of PACU discharge Aldrete scores between groups (9.9±0.3 vs. 9.6±0.4 in groups 1 and 2, respectively) (p=0.03). Finally, the time interval in PACU was 39.0±7.5 mins in group 1 while it was 58.8±14.0 mins in group 2 (p<0.0001). Conclusions: Severe obesity does not alter surgical outcomes in patients undergoing PNL under spinal anesthesia, and in our opinion, spinal anesthesia in PNL is a safe and effective anesthesia modality for renal stone(s) in obese and morbidly obese patients.

Keywords: obesity, PACU, PNL, spinal anesthesia, prospective
DOI :10.26650/IUITFD.2021.839546   IUP :10.26650/IUITFD.2021.839546    Full Text (PDF)

AĞIR OBEZİTE HASTALARIN SPİNAL ANESTEZİ ALTINDA PERKÜTAN NEFROLİTİTOMİ UYGULANMASI POSTOPERATİF ERKEN DÖNEM İYİLEŞME VE CERRAHİ SONUÇLARINI ETKİLER Mİ?

Ahmed Ömer Halat, Muhammet İrfan Dönmez, Murat Gönen, Ömer Erkam Arslan, Betül Başaran

Amaç: Bu çalışmanın birincil amacı, spinal anestezi altında perkütan nefrolititomi (PNL) uygulanan hastalarda ağır obezitenin erken postoperatif seyir üzerinde zararlı bir etkisinin olup olmadığını değerlendirmektir. İkinci olarak, ağır obezitenin cerrahi sonuçları değiştirip değiştirmediğini belirlemektir. Gereç ve Yöntem: Çalışmaya kliniğimizde ≥2cm böbrek taşı nedeniyle PNL operasyonu yapılan 100 hasta dahil edildi. Buna göre birinci grupta VKİ<35 kg/m2 olanlar, ikinci grupta ise ciddi derecede obez BKİ≥35 kg/m2 olanlar oluşturuldu. Yaş, cinsiyet, taş yükü, ameliyat öncesi/sonrası hemoglobin seviyeleri, giriş sayısı ve bölgeleri, ameliyat süresi, perioperatif komplikasyonlar ve 24. saatte Görsel Analog Skala skoru, PACU yatış/taburculuk Aldrete skorları ve PACU kalış süresi kaydedildi. Bulgular: Grup 1’de VAS puanı 5,0±1,3 iken grup 2’de 5,3±1,8 idi (p=0,32). Hastanede kalış süresi VKİ <35 kg/m2 olan hastalarda 3,3±1,3 gün, VKİ≥35 kg/m2 olan hastalarda 3,0±1,0 idi (p=0,36). Ağır obez grupta %98, normal vücut kitle indeksi grubunda %96 taşsızlık oranı saptandı ve gruplar arasında anlamlı fark yoktu (p=0,672). Gruplar arasında PACU taburcu Aldrete skorları açısından istatistiksel olarak anlamlı fark vardı (Grup 1 ve 2’de sırasıyla 9,9±0,3 ve 9,6±0,4) (p=0,03). Son olarak PACU’da zaman aralığı grup 1’de 39,0±7,5 dk iken grup 2’de 58,8±14,0 dk idi (p<0,0001). Sonuç: Şiddetli obezite, spinal anestezi altında PNL uygulanan hastalarda cerrahi sonuçları değiştirmez ve bize göre PNL’de spinal anestezi, obez ve morbid obez hastalarda renal taş(lar) için güvenli ve etkili bir anestezi yöntemidir.

Keywords: obezite, PACU, PNL, spinal anestezi, prospektif

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APA

Halat, A.Ö., Dönmez, M.İ., Gönen, M., Arslan, Ö.E., & Başaran, B. (2021). DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?. Journal of Istanbul Faculty of Medicine, 84(3), 354-359. https://doi.org/10.26650/IUITFD.2021.839546


AMA

Halat A Ö, Dönmez M İ, Gönen M, Arslan Ö E, Başaran B. DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?. Journal of Istanbul Faculty of Medicine. 2021;84(3):354-359. https://doi.org/10.26650/IUITFD.2021.839546


ABNT

Halat, A.Ö.; Dönmez, M.İ.; Gönen, M.; Arslan, Ö.E.; Başaran, B. DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?. Journal of Istanbul Faculty of Medicine, [Publisher Location], v. 84, n. 3, p. 354-359, 2021.


Chicago: Author-Date Style

Halat, Ahmed Ömer, and Muhammet İrfan Dönmez and Murat Gönen and Ömer Erkam Arslan and Betül Başaran. 2021. “DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?.” Journal of Istanbul Faculty of Medicine 84, no. 3: 354-359. https://doi.org/10.26650/IUITFD.2021.839546


Chicago: Humanities Style

Halat, Ahmed Ömer, and Muhammet İrfan Dönmez and Murat Gönen and Ömer Erkam Arslan and Betül Başaran. “DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?.” Journal of Istanbul Faculty of Medicine 84, no. 3 (Nov. 2024): 354-359. https://doi.org/10.26650/IUITFD.2021.839546


Harvard: Australian Style

Halat, AÖ & Dönmez, Mİ & Gönen, M & Arslan, ÖE & Başaran, B 2021, 'DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?', Journal of Istanbul Faculty of Medicine, vol. 84, no. 3, pp. 354-359, viewed 23 Nov. 2024, https://doi.org/10.26650/IUITFD.2021.839546


Harvard: Author-Date Style

Halat, A.Ö. and Dönmez, M.İ. and Gönen, M. and Arslan, Ö.E. and Başaran, B. (2021) ‘DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?’, Journal of Istanbul Faculty of Medicine, 84(3), pp. 354-359. https://doi.org/10.26650/IUITFD.2021.839546 (23 Nov. 2024).


MLA

Halat, Ahmed Ömer, and Muhammet İrfan Dönmez and Murat Gönen and Ömer Erkam Arslan and Betül Başaran. “DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?.” Journal of Istanbul Faculty of Medicine, vol. 84, no. 3, 2021, pp. 354-359. [Database Container], https://doi.org/10.26650/IUITFD.2021.839546


Vancouver

Halat AÖ, Dönmez Mİ, Gönen M, Arslan ÖE, Başaran B. DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?. Journal of Istanbul Faculty of Medicine [Internet]. 23 Nov. 2024 [cited 23 Nov. 2024];84(3):354-359. Available from: https://doi.org/10.26650/IUITFD.2021.839546 doi: 10.26650/IUITFD.2021.839546


ISNAD

Halat, AhmedÖmer - Dönmez, Muhammetİrfan - Gönen, Murat - Arslan, ÖmerErkam - Başaran, Betül. “DOES SEVERE OBESITY EFFECT EARLY POSTOPERATIVE RECOVERY AND SURGICAL OUTCOMES IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY UNDER SPINAL ANESTHESIA?”. Journal of Istanbul Faculty of Medicine 84/3 (Nov. 2024): 354-359. https://doi.org/10.26650/IUITFD.2021.839546



TIMELINE


Submitted15.11.2020
Accepted23.02.2021
Published Online12.07.2021

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