Outcomes of Retrograde Intrarenal Surgery Compared with Percutaneous Nephrolithotomy in Elderly Patients with Moderate-Size Kidney Stones: A Matched-Pair Analysis

Akman, Tolga; Binbay, Murat; Ugurlu, Mesut; Kaba, Mehmet; Akçay, Muzaffer; Yazıcı, Özgür; Özgör, Faruk; Müslümanoğlu, Ahmet Yaser

doi:10.1089/end.2011.0526

Cited by 60 publications

(65 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[16,17] Although RIRS has its advantage of minimal blood loss without visceral injury, yet its higher cost and maintenance of the flexible ureterorenoscopes are points of concern. [18,19] Percutaneous nephrolithotomy with its excellent stone clearance rates is a brilliant option for the treatment of renal stones especially staghorn calculi within a short time. [20][21][22][23] The main concern, however, with PCNL is bleeding which can be seen in up to 23% of cases.…”

Section: Discussionmentioning

confidence: 99%

Total tubeless ultra-mini supine percutaneous nephrolithotomy: A feasibility study

Gupta

Das

Pal

2018

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: The ultra-mini percutaneous nephrolithotomy (PCNL) for treating low-volume renal nephrolithiasis is being used as an alternative modality to the conventional PCNL. However its use in the supine position has been scarcely reported. Material and methods:Patients who underwent ultra-mini PCNL in the supine position within the time frame of January 2017 to July 2017 were studied. All these patients had this as their first-line treatment. The patients had calculus limited to either a single calyx or just extending to the pelvis and the stone size was less than 2 cm in its maximal dimension. An 8.5 Fr operating nephroscope was used. The patients were positioned in the Galdakao modified Valdivia supine position. The stones were fragmented using Holmium-YAG laser. Various surgical outcomes including duration of the surgery, stone-free rate and any subsequent complications-if any-were analyzed. Results:The study includes a series of 14 patients with 15 renal units (one patient treated with bilateral renal stone disease). The mean age of the patients was 39.07 years and body mass index was 25.5 kg/m 2 . Intrarenal stone location was as follows: lower calyx, n=8; middle calyx, n=3, upper calyx, n=1, and pelvis, n=3. Median operative time was 52.66 min (range: 40-70) and the stone-free rate was 93.3%. Only one patient had residual fragments and needed subsequent extracorporeal shock wave lithotripsy. Conclusion:Ultra-mini PCNL in supine position with a complete tubeless approach for renal stone disease is a safe method for treating low-volume disease. Studies with a larger cohort may be required to finally validate this technique.

show abstract

Section: Discussionmentioning

confidence: 99%

Total tubeless ultra-mini supine percutaneous nephrolithotomy: A feasibility study

Gupta

Das

Pal

2018

Turkish Journal of Urology

View full text Add to dashboard Cite

show abstract

“…The complications following PCnL might become important compared to younger patients. The worse cardiopulmonary reserve in elderly leads to less toleration to bleeding and septic complication in elderly patients and anesthetic risks are more serious as well (9). In general patients, major complications of PCnL are bleeding that requires intervention (0.6% -1.4%), infection (0.9 -4.7%), pulmonary complication (3.1 -23%) and adjacent organ injury (0.2%) (10).…”

Section: Discussionmentioning

confidence: 99%

“…Similar to the standard treatment of urolithiasis, extracorporeal shock wave lithotripsy is the most common modality in elderly for small stone with safety and efficacy (14). Akman et al (9) compared the outcome of retrograde intrarenal surgery with percutaneous nephrolithotomy in elderly. Mean hospital stay, fluoroscopic time, drop in hemoglobin level were significantly higher in PCnL patients.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of percutaneous nephrolithotomy: Comparison of elderly and younger patients

2013

View full text Add to dashboard Cite

Background and purpose: Percutaneous nephrolithotomy (PCnL) in elderly patients is challenging due to the high prevalence of comorbidity and single kidney. We compared the results and complications of patients who were submitted to PCnL according to age (higher than and lower than 65 years old). Materials and Methods: A total of 61 patients aged more than 65 years old (group I) and 385 patients aged 65 years old or less (group II) were treated with PCnL. PCnL was performed by a standard technique under fluoroscopic guidance. The operative time, length of hospital stay, success rate, auxiliary treatment and complications of both groups were compared. Results: Patients older than 65 years old (group I) had more comorbidities mainly diabetes mellitus, hypertension and higher level of ASA classification (P < 0.001). The success rate was 85.24% and 86.24% of groups I and II, respectively. Four patients (6.56%) of group I and 55 patients (14.29%) of group II needed auxiliary treatment (P = 0.098). Among the complications, only sepsis was significantly higher in group I (6.56% of group I and 1.3% of group II, P = 0.007). The operative time, success rate, hospital stay and complications except sepsis episode did not significantly differ between the two groups. Conclusion: Percutaneous nephrolithotomy is effective and safe in elderly patients even though with more comorbidities. Sepsis is the only more frequent common complication following PCnL in elderly.

show abstract

“…The declared stone free rate of RIRS is about 97%, complication rates are lower than in other initiatives [40] . RIRS can be considered a proper alternative to PCNL in cases with significant comorbidity (anticoagulation, cardiopulmonary disease, advanced age) [41] , and in cases with additional adverse anatomical factors such as obesity and renal malformations [42] . Giusti et al [43,44] [43] .…”

Section: Retrograde Intrarenal Surgerymentioning

confidence: 99%

Effect of urinary stone disease and its treatment on renal function

Mercimek

Özden

2015

WJN

View full text Add to dashboard Cite

Urolithiasis is a common disease that affects urinary tract in all age groups. Both in adults and in children, stone size, location, renal anatomy, and other factors, can influence the success of treatment modalities. Recently, there has been a great advancement in technology for minimally invasive management of urinary stones.The epoch of open treatment modalities has passed and currently there are much less invasive treatment approaches, such as percutaneous nephrolithotomy, ureteroscopy, shockwave lithotripsy, and retrograde internal Surgery. Furthermore, advancement in imaging technics ensures substantial knowledge that permit physician to decide the most convenient treatment method for the patient. Thus, effective and rapid treatment of urinary tract stones is substantial for the preservation of the renal function. In this review, the effects of the treatment options for urinary stones on renal function have been reviewed. Core tip: In this article, urinary stone disease, treatment options and its effects on renal function are examined. Moreover, in the light of recent publications, effect of treatment options on functional state of the kidney in patients with renal impairment is investigated.Mehmet NM, Ender O. Effect of urinary stone disease and its treatment on renal function. World

show abstract

Outcomes of Retrograde Intrarenal Surgery Compared with Percutaneous Nephrolithotomy in Elderly Patients with Moderate-Size Kidney Stones: A Matched-Pair Analysis

Abstract: RIRS has a low complication rate and represents a safe and effective treatment alternative in selected geriatric patients with kidney stones of moderate size.

Cited by 60 publications

References 22 publications

Total tubeless ultra-mini supine percutaneous nephrolithotomy: A feasibility study

Total tubeless ultra-mini supine percutaneous nephrolithotomy: A feasibility study

Outcomes of percutaneous nephrolithotomy: Comparison of elderly and younger patients

Effect of urinary stone disease and its treatment on renal function

Contact Info

Product

Resources

About