ArticleUrology2018
Increasing Body Mass Index Steepens the Learning Curve for Ultrasound-guided Percutaneous Nephrolithotomy.
Article in Urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 27 citations in OpenAlex.
- From body mass index to waist circumference: a paradigm shift in assessing access complexity in percutaneous nephrolithotomy- comparative study.Urolithiasis · 2025Article
- Evaluating the learning curve of total ultrasound guided percutaneous nephrolithotomy in complex renal stones using"30-degree triangulation"technique.World journal of urology · 2025Article
- Can Doppler ultrasound reduce hemorrhagic complications in ultrasound-guided percutaneous nephrolithotomy for solitary kidney stones?Frontiers in surgery · 2025Article
- Visually navigated, ultrasound-guided, freehand percutaneous calyceal puncture - preclinical evaluation of a novel device to simplify a complex surgical task.Ultrasound international open · 2024Article
- Ultrasound-Guided PCNL - Why Are We Still Performing Exclusively Fluoroscopic Access?Current urology reports · 2023Review
- Low-dose fluoroscopy technique drastically decreases patient radiation exposure during percutaneous nephrolithotomy.Urolithiasis · 2022Article
- Percutaneous nephrolithotomy with ultrasound-assisted puncture: does the technique reduce dependence on fluoroscopic ionizing radiation?World journal of urology · 2021Article
- Tract dilation monitored by ultrasound in percutaneous nephrolithotomy: feasible and safe.World journal of urology · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo define how the learning curve for success in ultrasound-guided percutaneous nephrolithotomy (PCNL) is impacted by body mass index (BMI). Previous research has shown ultrasound-guided PCNL to be an effective method of nephrolithiasis treatment comparable to fluoroscopy-guided PCNL. A common concern for the ultrasound-guided approach is potential imaging difficulty in the obese patient population.
methodsA prospective cohort study of consecutive patients undergoing PCNL with ultrasound guidance for renal tract access was performed. Clinical data collected included success in gaining renal access with ultrasound guidance, patient BMI, and clinical outcomes over time. Nonparametric LOWESS regression modeling was performed in R using locally weighted scatterplot smoother (R version 3.3.3) for gradations of patients by BMI group (<30, 30-40, and >40).
resultsA total of 150 cases were examined. Case number and BMI were evaluated as continuous variables. Multivariate logistic regression revealed that BMI (P = .010; OR 0.93) and case number (P<.001; OR 1.03) were significantly correlated with ultrasound success. Sex, age, hydronephrosis, stone type, puncture location, and stone size did not influence success at obtaining ultrasound-only access in a statistically significant fashion. LOWESS regression modeling of the relationship between case number and renal access success depicts that the curve representative of the BMI >40 group is downward and right-shifted relative to the other two groups.
conclusionThe learning curve for successful ultrasound-guided PCNL is impacted by patient's BMI as well as case number. Increasing BMI makes access more challenging when performing ultrasound-guided PCNL.
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