Sahin A, Atsü N, Erdem E, Oner S, Bilen C, Bakkaloğlu M, Kendi S
Department of Urology, Hacettepe University Medical School, Ankara, Turkey.
J Endourol. 2001 Jun;15(5):489-91. doi: 10.1089/089277901750299276.
To assess the safety and efficacy of percutaneous nephrolithotomy in patients more than 60 years old.
We retrospectively evaluated and compared the data of 28 percutaneous nephrolithotomies (PCNL) performed on 27 patients aged 60 years and older (mean 65.8) with the data of the remaining 178 PCNL procedures on 166 patients performed in our clinic between December 1997 and December 1999.
Although staghorn stones seemed to be more common in the elderly group (25% v 22%), no statistical significance was demonstrated (P = 0.715), and the stone burden was similar for the two groups (P = 0.112). The only interesting finding in terms of patient characteristics was a significantly higher incidence of solitary kidney in patients aged 60 years or older (29% v 7%; P = 0.003). The success rates (stone-free patients and patients with residual stones <4 mm) were similar, being 89% for the elderly group and 92% for the younger patients (P = 0.718). Transfusion rates were also similar (21.4% in the elderly v 18% in the younger group; P = 0.662). No significant complication was observed in this elderly group, and no renal deterioration has been detected even in the follow-up of patients with a solitary kidney.
Despite the somewhat higher stone burden in the elderly patients (1077.92 mm2 v 920.85 mm2), the stone-free rate was similar to that obtained in the younger patients, without any higher rates of complications or blood transfusions or longer hospital stay. Percutaneous nephrolithotomy is a safe and effective method of stone treatment in the elderly, even if they have a solitary kidney or complex calculi.
评估经皮肾镜取石术在60岁以上患者中的安全性和有效性。
我们回顾性评估并比较了27例年龄在60岁及以上（平均65.8岁）患者接受的28例经皮肾镜取石术（PCNL）的数据，以及1997年12月至1999年12月间在我们诊所对166例患者施行的其余178例PCNL手术的数据。
尽管鹿角形结石在老年组似乎更为常见（25%对22%），但未显示出统计学意义（P = 0.715），且两组的结石负荷相似（P = 0.112）。就患者特征而言，唯一有趣的发现是60岁及以上患者中孤立肾的发生率显著更高（29%对7%；P = 0.003）。成功率（结石清除患者及残余结石<4 mm的患者）相似，老年组为89%，年轻患者组为92%（P = 0.718）。输血率也相似（老年组为21.4%，年轻组为18%；P = 0.662）。该老年组未观察到显著并发症，即使在对孤立肾患者的随访中也未检测到肾功能恶化。
尽管老年患者的结石负荷略高（1077.92 mm²对920.85 mm²），但结石清除率与年轻患者相似，且并发症、输血率或住院时间均未升高。经皮肾镜取石术是老年患者结石治疗的一种安全有效的方法，即使他们有孤立肾或复杂性结石。
