Does aging affect the outcome of percutaneous nephrolithotomy?

Abstract

To investigate whether aging affects surgical outcomes by comparing the results of two patient groups undergoing PNL: those over 60 and those under 60. A retrospective screen was made for patients undergoing conventional PNL surgery for renal stones performed in two separate centers between 2010 and 2013. 520 patients included were classified into age groups: patients aged 18-59 comprised Group-1 and those aged over 60 comprised Group-2. Those between 60-69 years (sexagenarian) were assigned to Group-2a; 70-79 years (septuagenarian) to Group-2b; and 80-89 years (octogenarian) to Group-2c. Patients' demographic characteristics (accompanying comorbidities, ASA scores, body mass indices and stone size) and perioperative values (duration of surgery and hospital stay, success and complication rates) were compared between the groups. Mean stone size was similar in groups (30.1 ± 15.5 vs. 31.5 ± 15.4 mm, p = 0.379). The mean ASA value for the patients in Group-1 was 1.61; significantly lower than that in the other groups (p = 0.000). The level of accompanying comorbidities in Group-1 was significantly lower than that of the other groups (p = 0.000). The mean duration of surgery, postoperative hematocrit drop, complication and success rate were statistically similar in Groups 1 and 2 (p = 0.860, p = 0.430, p = 0.7, and p = 0.66, respectively). The duration of hospital stay was significantly shorter in the patients in Group-1 compared to those in Group-2 (p = 0.008). In experienced hands, PNL can be safely and reliably performed in the treatment of renal stones in elderly patients.

Percutaneous Nephrolithotomy (PCNL) in Older and Younger Patients at a Tertiary Hospital in Surabaya, Indonesia

“…Diabetes mellitus was the comorbidity that exhibited a significant difference between the older and younger age groups, with 30.8% of the older patients having diabetes mellitus compared to 18.9% of the younger patients (p=0.071). Similar findings were discovered in two prior studies by Abedali et al (2019) and Buldu et al (2015), in which diabetes mellitus was shown to be considerably more prevalent in the older age group investigated. In a study conducted by Wei et al (2015), diabetes was found to be significantly associated with an increased frequency of postoperative and infectious complications following PCNL.…”

Perkütan Nefrolitotomi Yaşlı Hastalarda Korkutucu Değildir: Tek Merkez Sonuçları

“…Kuzgunbay et al (15) evaluated the results of 300 PNL procedures, and Nakamon et al (16) examined 446 patients who had undergone PNL; there were no statistically significant differences in the length of hospital stay when both elderly and younger patients were compared in these two series. However, other reports have found that elderly patients had a longer hospital stay compared with younger patients (11). Our results indicated that the average length of stay was three days in Group 1 and four days in Group 2, which was not statistically significant (p: 0.164).…”

“…Buldu et al (11) investigated whether aging impacted surgical outcomes in PNL and did not find a statistically significant difference in the mean duration of surgery, postoperative hematocrit drop, or the complication and success rates between younger and elderly groups. Similarly, in our study, the stone-free, clinically insignificant residual fragment , and clinically significant residual fragment rates were 66.2%, 8.2%, and 25.6%, respectively, in Group 1 and 71.9%, 3.1%, and 25%, respectively, in Group 2; no significant difference was observed (p: 0.569).…”

Geriatrik Hastalarda Perkütan Nefrolitotominin Güvenilirliğinin ve Komplikasyonları Etkileyen Faktörlerin Değerlendirilmesi

“…Anagnostou et al showed that they achieved stone-free 73.3% in the geriatric group with a stone burden of 56.7 mm 3 , indistinguishable from the youth (15). Over the years, stone-free rates in the elderly have also increased and reached 90% in the literature (16). In this case, the experience of the surgeon is also an important factor (17).…”