Percutaneous Nephrolithotomy in the 80 Years of Age and Older Population

Abedali, Zain A.; Large, Tim; Heiman, Joshua; Bandali, Elhaam; Anderson, Blake; Lingeman, James E.; Krambeck, Amy E.

doi:10.1016/j.urology.2019.08.044

Cited by 14 publications

(13 citation statements)

References 15 publications

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“…These factors lead to the deterioration of cardiopulmonary reserve, increased risk of surgical anesthesia, and increased risk of bleeding and septic complications, which may be fatal in the elderly population. The incidence of complications in this study was 13.8%, which was similar to that reported in the literature [ 3 , 6 – 10 ] (Table 5 ). Through a multifactor analysis of factors related to complications, we found that ASA grade III was an independent risk factor for complications following PCNL in the elderly.…”

Section: Discussionsupporting

confidence: 90%

Efficacy and safety of percutaneous nephrolithotripsy in elderly patients: a retrospective study

Xu³

et al. 2022

BMC Surg

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Background Percutaneous nephrolithotripsy (PCNL) is difficult to perform for elderly patients; thus, this study aimed to assess its efficacy and safety in elderly patients aged > 70 years, note any associations between outcomes and patient characteristics, and summarize relevant themes and observations. Methods Data from patients older than 70 years who had undergone PCNL for upper urinary tract calculi between January 2016 and January 2021 was retrospectively analyzed. Risk factors for postoperative complications and residual stones were analyzed using multivariate logistic regression. Results A total of 116 elderly patients underwent 122 PCNL operations, of which six underwent secondary PCNL operations, and all of which were successfully completed. The average age was 74.6 ± 4.3 years; the average stone size and operation time were 3.5 ± 1.8 (1.2–11 cm), and 71.8 ± 34.1 min, respectively. Of the participants, 16 or 13.8% had postoperative complications and 29 (25%) had residual stones after operation. The stone free rate was 75%. Multivariate analysis revealed that an American Score of Anesthesiology III was an independent risk factor for postoperative complications (odds ratio [OR] = 4.453, p = 0.031), and staghorn calculi were independent risk factors for postoperative residual calculi (OR = 31.393, p = 0.001). Conclusion PCNL was shown to be safe and effective for elderly patients aged > 70 years. Further, ASA III was an independent risk factor for postoperative complications, and staghorn calculi were independent risk factors for postoperative residual calculi in elderly patients.

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Section: Discussionsupporting

confidence: 90%

Efficacy and safety of percutaneous nephrolithotripsy in elderly patients: a retrospective study

Xu³

et al. 2022

BMC Surg

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“…While PNL has high complication rates, other minimally invasive procedures such as SWL and URS do not seem innocent due to factors such as increased comorbidity and drug use in the elderly (8,9). Our study demonstrates that PNL surgery, which has the highest treatment success in large stones, can be used safely in the geriatric population with low morbidity, in parallel with the literature (10)(11)(12).…”

Section: Discussionsupporting

confidence: 70%

Geriatrik Hastalarda Perkütan Nefrolitotominin Güvenilirliğinin ve Komplikasyonları Etkileyen Faktörlerin Değerlendirilmesi

Alkış

Kartal

Aras

et al. 2021

Ankara Eğitim Ve Araştırma Hastanesi Tıp Dergisi

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This study aims to investigate the safety and efficacy of percutaneous nephrolithotomy (PNL) in the elderly. Material and Method: The data of 238 patients who underwent PNL between January 2015 and January 2020 were retrospectively analyzed. A total 238 patients were divided into two groups made up of 86 elderly (above 65 years old) and 152 non-elderly persons (under 65 years old). Demographic data, stone characteristics, operation data, and complications were compared between the elderly and non-elderly patients.RESULTS: Eighty-six (36.1%) elderly patients were included in the study. There was no significant difference between the groups in terms of demographic characteristics, success, and complication rates (p>0.05). The overall stone-free rate was 86.0% in the elderly and 86.8% in non-elderly (p>0.05). In multivariable analysis; stone size (p=0.032, OR=0.202 and 95% CI=0.047-0.873) and number of stones (p=0.002, OR=0.067 and 95% CI=0.012-0.377) were found to be associated with complications in elderly.CONCLUSION: Percutaneous Nephrolithotomy can be performed safely with high success in elderly patients. It should be kept in mind that the risk of complications for PNL is increased in geriatric patients with a high number of stones and burden.

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“…However, blood transfusion rates were reportedly higher in elderly patients compared with younger patients following PNL (13). Abedali et al (14) reported that the transfusion rate was 10.2% in patients >80 years who underwent PNL and statistically higher compared with younger groups (p <0.001). Besiroglu et al (12) demonstrated a 13.3% transfusion rate in their >70-year-old group, and there was no statistically significant difference between their younger groups (p: 0.15).…”

Section: Discussionmentioning

confidence: 96%

Perkütan Nefrolitotomi Yaşlı Hastalarda Korkutucu Değildir: Tek Merkez Sonuçları

Atik¹,

Çimen²,

Gül³

et al. 2020

Yeni Üroloji Dergisi

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PNL operasyonu uygulanan 70 yaş üstü hastaların postoperatif sonuçlarını değerlendirmek ve daha gençı hastalar ile karşılaştırmak. Gereç ve Yöntemler: Kurumumuzda 2016-2019 yılları arasında 2 cm' den büyük böbrek taşı için konvansiyonel PNL operasyonu uygulanan 508 hastanın verisini retrospektif olarak değerlendirdik. Hastalar yaşlarına göre iki gruba ayrıldı. 70 yaş ve üstü hastalar grup 2, 70 yaşından küçük hastalar grup 1 olarak ayrıldı. Gruplar arasında hastaların komorbiditeleri, ASA skorları, vücut kitle indeksleri (VKİ), taş boyutu gibi demografik verileri ve ameliyat süresi, floroskopi süresi, komplikasyon oranı, hastanede kalış süresi ve taşsızlık oranı gibi perioperatif ve postoperatif değerleri karşılaştırıldı. Bulgular: Grup 1' de 476 hasta, Grup 2' de 32 hasta mevcuttu. Ortalama yaş, yaşlı hasta grubunda 73 (70-86), genç hasta grubunda 48 (18-69) idi. Gruplar arasında multipl taş oranı, operasyon süresi, floroskopi süresi, hastanede kalış süresi, taşsızlık oranı ve komplikasyon oranları açısından fark yoktu. Ameliyat öncesi taş büyüklüğü, staghorn taş oranı ve transfüzyon oranı yaşlı hastalarda genç gruba göre anlamlı olarak yüksekti (sırasıyla; p = 0.027, 0.009, 0.003). Sonuç: PNL, büyük böbrek taşına sahip yaşlı hastalarda kabul edilebilir sonuçlara sahiptir ve güvenle uygulanabilir.

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Percutaneous Nephrolithotomy in the 80 Years of Age and Older Population

Cited by 14 publications

References 15 publications

Efficacy and safety of percutaneous nephrolithotripsy in elderly patients: a retrospective study

Efficacy and safety of percutaneous nephrolithotripsy in elderly patients: a retrospective study

Geriatrik Hastalarda Perkütan Nefrolitotominin Güvenilirliğinin ve Komplikasyonları Etkileyen Faktörlerin Değerlendirilmesi

Perkütan Nefrolitotomi Yaşlı Hastalarda Korkutucu Değildir: Tek Merkez Sonuçları

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