OUTCOMES OF PERCUTANEOUS NEPHROLITHOTOMY IN ELDER AGE PATIENTS-SINGLE CENTER EXPERIENCE
Abstract
Background: Urolithiasis is a prevailing ailment affecting all age groups across global population. In modern innovative industry endoscopic instruments alterations and miniaturization has simplified the interventional strategy for undertaking these procedures for renal stones. However, there has been paucity of studies regarding outcomes of Percutaneous Nephrolithotomy (PCNL) in elder age group. We aimed to report success rates and complications in elder age group. Methods: This was a retrospective review of the charts for subjects that underwent unilateral PCNL from 2012 till 2018 November at a tertiary care hospital at capital of Pakistan. Patients of age ‰¥60 years were chosen for this study. PCNL procedures were done in prone position. We implemented the Guy stone scoring (stone complexity) to forecast the net results of PCNL. Information regarding variables were recorded in specified proforma and then processed in SPSS version 16 for the statistical computations. Results: On the whole 79 patients were incorporated for this study. Most common presenting complaint in clinic was flank pain followed by haematuria and fever respectively. Mean age in this analysis was calculated as 63.36±5.19 years. Mean size for calculi was 449±163mm2. One patient underwent transfusion after surgery while only 2.5% of these patients had sepsis (post PCNL procedure). Stone free rate was significantly affected by Guys stone score (GSS). Conclusion: PCNL can be undertaken safely and effectually for achieving treatment goals even in elder subjects. Stone free rates are higher in lower Guys stone score as compared to the higher scores.
References
Lieske JC, Peña de la Vega LS, Slezak JM, Bergstralh EJ, Leibson CL, Ho KL, et al. Renal stone epidemiology in Rochester, Minnesota: an update. Kidney Int 2006;69(4):760-4.
Smith R, Osterweil D, Ouslander JG. Perioperative care in the elderly urologic patient. Urol Clin North Am 1996;23(1):27-41.
Iqbal N, Malik Y, Nadeem U, Khalid M, Pirzada A, Majeed M, et al. Comparison of ureteroscopic pneumatic lithotripsy and extracorporeal shock wave lithotripsy for the management of proximal ureteral stones: A single center experience. Turk J Urol 2018;44(3):221-7.
Knoll T, Schubert AB, Fahlenkamp D, Leusmann DB, Wendt-Nordahl G, Schubert G. Urolithiasis through the ages: data on more than 200,000 urinary stone analyses. J Urol 2011;185(4):1304-11.
Romero V, Akpinar H, Assimos DG. Kidney stones: A global picture of prevalence, incidence, and associated risk factors. Rev Urol 2010;12(2-3):e86-96.
Ng CF, Wong A, Tolley D. Is extracorporeal shock wave lithotripsy the preferred treatment option for elderly patients with urinary stone? A multivariate analysis of the effect of patient age on treatment outcome. BJU Int 2007;100(2):392-5.
Bartoletti R, Cai T, Mondaini N, Melone F, Travaglini F, Carini M, et al. Epidemiology and risk factors in urolithiasis. Urol Int 2007;79(Suppl 1):3-7.
Usui Y, Matsuzaki S, Matsushita K, Shima M. Urolithiasis in geriatric patients. Tokai J Exp Clin Med 2003;28(2):81-7.
Routh JC, Graham DA, Nelson CP. Epidemiological trends in pediatric urolithiasis at United States freestanding pediatric hospitals. J Urol 2010;184(3):1100-4.
Shohab D, Iqbal N, Alam MU, Butt A, Jamil M I, Hussain, Akhter S. Comparison of Outcome of Percutaneous Nephrolithotomy in Adult Versus Paediatric Patients. J Coll Physicians Surg Pak 2016;26(5):371-3.
Sighinolfi MC, Micali S, Grande M, Mofferdin A, De Stefani S, Bianchi G. Extracorporeal shock wave lithotripsy in an elderly population: How to prevent complications and make the treatment safe and effective. J Endourol 2008;22(10):2223-6.
McCarthy JP, Skinner TA, Norman RW. Urolithiasis in the elderly. Can J Urol 2011;18(3):5717-20.
Thomas K, Smith NC, Hegarty N, Glass JM. The Guy's stone score--grading the complexity of percutaneous nephrolithotomy procedures. Urology 2011;78(2):277-81.
Ng CF. The effect of age on outcomes in patients undergoing treatment for renal stones. Curr Opin Urol 2009;19(2):211-4.
Stoller ML, Bolton D, St Lezin M, Lawrence M. Percutaneous nephrolithotomy in the elderly. Urology 1994;44(5):651-4.
Resorlu B, Diri A, Atmaca A, Tuygun C, Oztuna D, Bozkurt O, et al. Can we avoid percutaneous nephrolithotomy in high-risk elderly patients using the charlson comorbidity index? Urology 2012;79(5):1042-7.
Nakamon T, Kitirattrakarn P, Lojanapiwat B. Outcomes of percutaneous nephrolithotomy: comparison of elderly and younger patients. Int Braz J Urol 2013;39(5):692-700.
Krambeck AE, Lieske JC, Li X, Bergstralh EJ, Melton LJ 3rd, Rule AD. Effect of age on the clinical presentation of incident symptomatic urolithiasis in the general population. J Urol 2013;189(1):158-64.
Iqbal N, Assad S, Hussain I, Hassan Y, Khan H, Farooq MA, et al. Comparison of outcomes of tubed versus tubeless percutaneous nephrolithotomy in children: A single center study. Turk J Urol 2018;44(1):56-61.
Akman T, Binbay M, Sari E, Yuruk E, Tepeler A, Akcay M, et al. Factors affecting bleeding during percutaneous nephrolithotomy: single surgeon experience. J Endourol 2011;25(2):327-33.
Seitz C, Desai M, Häcker A, Hakenberg OW, Liatsikos E, Nagele U, et al. Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol 2012;61(1):146-58.
de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 2012;62(2):246-55.
Lee LC, Violette PD, Tailly T, Dave S, Denstedt JD, Razvi H. A comparison of outcomes after percutaneous nephrolithotomy in children and adults: a matched cohort study. J Pediatr Urol 2015;11(5):250.e1-6.
Sahin A, Astu N, Erdem E, Oner S, Bilen C, Bakkaloglu M, et al. Percutaneous nephrolithotomy in patients aged 60 years or older. J Endourol 2001;15(5):489-91.
Okeke Z, Smith AD, Labate G, D'Addessi A, Venkatesh R, Assimos D, et al. Prospective comparison of outcomes of percutaneous nephrolithotomy in elderly patients versus younger patients. J Endourol 2012;26(8):996-1001.
Ozturk H. Tubeless versus standard PCNL in geriatric population. Actas Urol Esp 2015;39(8):494-501.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
