Predicting Percutaneous Nephrolithotomy Outcomes and Complications in Elderly Patients Using Guy's Scoring System and Charlson Comorbidity Index

Tseng, Jen Shu; Lin, Wun Rong; Sun, Fang; Lin, Tsu Feng; Tsai, Wei Kung; Chiang, Pai Kai; Lee, Chih Chiao; Chen, Yu Hsin; Chiu, Allen W.; Chen, Marcelo

doi:10.1016/j.ijge.2018.05.001

Cited by 2 publications

(1 citation statement)

References 35 publications

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“…As the global population ages, the surge in older individuals with comorbidities demands careful consideration in surgical interventions, particularly in stone disease management. The analysis from the Clinical Research Office of the World Endourological Society confirms the low complication rates and efficacy of F-URS 10,11 .…”

Section: Discussionmentioning

confidence: 70%

Assessing safety and efficacy of flexible ureteroscopy and laser lithotripsy in elderly patients

Álvarez-Villarraga,

García-Perdomo,

Ramírez-Vásquez

et al. 2024

RUC

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Objective:The objective of the study was to determine the efficacy and safety of flexible ureteroscopy (F-URS) for the management of intrarenal or proximal ureteral lithiasis in aged patients. Materials and methods: In this retrospective, multicenter observational study, we collected the anonymized clinical data of patients who underwent F-URS at two institutions in Cali, Colombia between June 2015 and May 2018. The patients were divided into two groups based on age: Group A defined as aged patients (> 65 years) and Group B as patients of non-advanced age (< 65 years). Results: A total of 201 patients were included in this study. The average age for Group A was 75 years (± 4.5) and for Group B was 51 years (± 10). The anesthetic risk classification (American Society of Anesthesiology [ASA]) and comorbidities were significantly higher for Group A with an ASA II and III of 74% versus 50% in Group B. No significant differences were shown in the stone-free rates (SFRs) or significant ureteral injury (Grade III and IV). There was no difference in intraoperative or post-operative complications between both groups. Conclusions: Age > 65 years was not associated with a negative impact on the outcomes of F-URS for the management of intrarenal or proximal ureteral lithiasis in this cohort of patients. F-URS appears as a safe and effective procedure and should not be withheld from older patients.

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Section: Discussionmentioning

confidence: 70%

Assessing safety and efficacy of flexible ureteroscopy and laser lithotripsy in elderly patients

Álvarez-Villarraga,

García-Perdomo,

Ramírez-Vásquez

et al. 2024

RUC

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Safety and efficacy of percutaneous nephrolithotripsy in comorbid patients: A 3 years prospective observational study

Abouelgreed,

Ismail,

Ali

et al. 2023

Arch Ital Urol Androl

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Purpose: To report the result of percutaneous nephrolithotripsy (PCNL) via standard nephrostomy tract in a single training institution. The perioperative complications in relation to the comorbid state are particularly assessed. Patients and methods: A prospective interventional study between January 2019 to November 2022, included 210 patients scheduled for PCNL. The average age was 40.3 ± 11.8 years (range 18- 67 years). Patients were categorized into two groups. The first group comprised 146 cases (69 .5%) with no associated co-morbidities while the second group 64 (30.5%) had co-morbidities such as obesity in 4 cases (1.9%), hypertension (HTN) in 24 cases (11.4%) cases, diabetes mellitus (DM) in 17 (8.1%) cases, history of recurrent stone surgery in 11 (5.2%) cases and more than one in 8 cases (3.8%). Co-morbidities, stone burden, location of stone, time of surgery, stay in the hospital, further operations, and negative events were among the reported data. Complications and the stone-free rate were the main outcome indicators. Results: Intraoperative complications were reported in 40 (18.8%) patients (18 group 1 and 22 group 2) during PCNL. Bleeding occurred in 22 (10.5%) patients (9 group 1 and 13 group 2), blood transfusions were needed in 4 (1.9%) (2 group 1 and 2 group 2), extravasation was observed in 11 patients (5.2%) (6 group 1 and 5 group 2) and cardiac arrhythmia in 3 (1.4%) (1 group 1 and 2 group 2) patients. Postoperative complications occurred in 61 patients (29%) (24 group 1 and 37 group 2) in the form of fever in 10 patients (4.8 %) (3 group 1 and 7 group 2) and prolonged leakage in 50 patients (23.8%) (21 group 1 and 29 group 2). One patient of group 2 died from postoperative sepsis. Extravasation and postoperative leakage were higher in diabetic patients than in non-diabetics. Stonefree rate was 60.5% (127 of 210). Clinically significant residual fragments (CSRFs) found in 70 cases (33.3%) (33 group 1 and 37 group 2). In 13 cases (6.2%) (5 group 1 and 8 group 2), clinically insignificant residual fragments (CIRFs) were found. In 8 (3 group 1 and 5 group 2) of the 13 cases, spontaneous stone passage was observed within 4-6 weeks of surgery. Residual stones in three cases (1 group 1 and 2 group 2) were asymptomatic and 4 mm or less, whereas stones increased in two cases of group 2. Among all factors studied, stone burden was significantly correlated to both intraoperative and postoperative complications. The occurrence of postoperative fever increased with large stone burden. Conclusions: PCNL is a therapeutic modality that is effective, feasible, and safe for a wide range of patients with concurrent medical issues. A steep curve is required to reduce intraoperative and postoperative complications.

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Predicting Percutaneous Nephrolithotomy Outcomes and Complications in Elderly Patients Using Guy's Scoring System and Charlson Comorbidity Index

Cited by 2 publications

References 35 publications

Assessing safety and efficacy of flexible ureteroscopy and laser lithotripsy in elderly patients

Assessing safety and efficacy of flexible ureteroscopy and laser lithotripsy in elderly patients

Safety and efficacy of percutaneous nephrolithotripsy in comorbid patients: A 3 years prospective observational study

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