Percutaneous nephrolithotomy in octogenarians and beyond: How old is too old?
نویسندگان
چکیده
Objective To specifically report perioperative characteristics and outcomes in patients 80 years and older undergoing percutaneous nephrolithotomy (PCNL). PCNL has been established as feasible in the elderly; however, to our knowledge no one has specifically reported feasibility in patients 80 years and older. Methods We retrospectively reviewed perioperative data of octogenarians who underwent PCNL at a high stone volume single institution, and matched them to patients <65 years of age by stone burden and sex. Patient demographics, perioperative outcomes and postoperative complications were compared. Results Thirty-three octogenarians (mean age 83.6 years) with 36 renal units were matched to 67 controls (mean age 48.6 years) with 72 renal units. Octogenarians had a higher mean American Society of Anesthesiologists (ASA) score, more comorbidities, and worse renal function. There were no differences in operative characteristics, length of hospital stay or stone free rates. Of the patients with preoperative urinary decompression (ureteral stent or nephrostomy tube) prior to PCNL, the elderly were more likely to have a history of urosepsis. Octogenarians did not experience more minor Clavien (I - II) or major Clavien (IIIa - IVb) complications. Conclusion Octogenarians who undergo PCNL were more likely to have cardiovascular comorbidities and a prior history of sepsis. Despite these risk factors, in appropriately selected patients PCNL can be safely and successfully performed in octogenarians without increased perioperative complications relative to a younger cohort.
منابع مشابه
Safety and efficacy of the Percutaneous Nephrolithotomy in Pediatrics; A 10-year single-center experience in Iran
Background: The aim of this study was to describe the one-decade experience in Percutaneous Nephrolithotomy surgery in children with kidney stones in Tehran, Iran. Methods: All patients (less than 18 years old) undergoing Percutaneous Nephrolithotomy at our referral medical center, were reviewed in this cross-sectional study. All the demographics, surgical data and post-operative information...
متن کاملOutcomes of percutaneous nephrolithotomy: comparison of elderly and younger patients.
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...
متن کاملManagement of the Retained Percutaneous Nephrostomy Catheter
Percutaneous nephrolithotomy is a widely accepted treatment for urinary calculi, but it is not without complications. We present the case of a 76-year-old male with a retained council tip catheter after percutaneous nephrolithotomy. Fluoroscopic guidance was used to perform percutaneous puncture of the catheter balloon, and the catheter was removed without complication. Advantages of various ne...
متن کاملNephropleural Fistula Effectively Managed with Serial Thoracentesis: A Case Report
Nephropleural fistulae are rare but serious thoracic complications of percutaneous nephrolithotomy (PCNL). Herein, we present the management of a 54-year-old female with a delayed presentation of nephropleural fistula. The role of serial thoracentesis as a safe, less invasive, less painful alternative to tube thoracostomy is highlighted. In select cases, this may represent an attractive managem...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 2 شماره
صفحات -
تاریخ انتشار 2015