School of Medicine, Department of Urology, Baskent University, Ankara, Turkey.
Int Urol Nephrol. 2011 Sep;43(3):639-43. doi: 10.1007/s11255-010-9885-6. Epub 2010 Dec 29.
We retrospectively analyzed the results of percutaneous nephrolithotomy operations for treatment of staghorn kidney stone disease in elderly patients and compared surgical parameters and outcomes with a control group of young adult patients.
Between 2002 and 2010, 300 consecutive patients underwent percutaneous nephrolithotomy operation for treatment of staghorn kidney stone disease. Forty-five of the patients were older than 65 years and considered to be in elderly group. Thirty-seven of the patients were between the ages 18 and 36 years and considered to be the control group. Surgical parameters and outcomes were compared between groups.
There were no significant differences between groups for stone area, operation time, difference in hemoglobin levels before and after surgery, blood transfusion rate, and length of hospital (P = 0.230, P = 0.106, P = 0.395, P = 0.691, and P = 0.690, respectively). Success rates after the operations were 53% in elderly group and 38% in young adult group. The difference for the outcomes of the operations was statistically insignificant (P = 0.365). Thirty-three (73%) of the patients had associated comorbid diseases in elderly group, while no patients had any comorbid disease in control group. Statistical analyses revealed no significant relation between the presence of comorbid diseases or ipsilateral renal surgery with success rate of the operation in the elderly group (P = 0.26 and P = 0.222, respectively).
The management of kidney stone disease by percutaneous nephrolithotomy in elderly patients is an adequate treatment modality even in the presence of complete staghorn calculi, comorbid diseases or previous ipsilateral renal surgery.
我们回顾性分析了经皮肾镜取石术治疗鹿角状肾结石的老年患者的结果，并与年轻成年患者的对照组进行了手术参数和结果比较。
2002 年至 2010 年间，300 例连续患者接受经皮肾镜取石术治疗鹿角状肾结石。45 例患者年龄大于 65 岁，被认为属于老年组。37 例患者年龄在 18 至 36 岁之间，被认为是对照组。比较两组之间的手术参数和结果。
两组患者的结石面积、手术时间、手术前后血红蛋白水平差异、输血率和住院时间均无显著差异（P=0.230、P=0.106、P=0.395、P=0.691、P=0.690）。老年组术后成功率为 53%，年轻成年组为 38%。手术结果差异无统计学意义（P=0.365）。老年组 33 例（73%）患者合并合并症，对照组无患者合并合并症。统计分析显示，合并症或同侧肾手术的存在与老年组手术成功率之间无显著关系（P=0.26 和 P=0.222）。
即使存在完全鹿角状结石、合并症或同侧肾手术史，经皮肾镜取石术治疗老年患者肾结石也是一种合适的治疗方法。
