Arthur Smith Institute for Urology, North Shore-Long Island Jewish Health System, New York, New York, USA.
J Endourol. 2012 Aug;26(8):996-1001. doi: 10.1089/end.2012.0046. Epub 2012 May 23.
The purpose of the study was to prospectively compare operative and postoperative characteristics and outcomes in elderly patients undergoing percutaneous nephrolithotomy (PCNL) compared with younger patients.
Prospectively collected data from the Clinical Research Office of the Endourological Society (CROES) Global PCNL Study database were used. Elderly patients were defined as those aged 70 years and above, while younger patients were those between 18 and 70 years of age. Matched and unmatched group comparisons were performed based on imaging modality used for assessing stone-free status. Patient characteristics, operative data, and postoperative outcomes were compared.
The median age of the elderly group vs the young group was 74 years (range 70-93 years) vs 49 years. In the unmatched analysis, staghorn stones were seen at higher rates in the elderly group (27.8% vs 21.8%, P=0.014); however, the mean stone size was not significantly different (465.0 vs 422.8, P=0.063). The length of hospitalization was significantly longer in the elderly group compared with the young group in the unmatched analysis (5 days vs 4.1 days, P<0.001). The same difference was not apparent in the matched analysis (5.0 days vs 4.4 days, P=0.288). Overall complication rates were not significantly different in the unmatched analysis. In the matched analysis, however, a statistically significant higher rate of overall complications was seen. Stone-free rates were similar among all groups.
PCNL in elderly patients over the age of 70 years produces results comparable to those seen in younger patients. With only a slightly higher-be it statistically significant-complication rate, the stone-free rate in older patients was the same as in the younger group.
本研究旨在前瞻性比较接受经皮肾镜取石术（PCNL）的老年患者与年轻患者的手术和术后特点及结局。
使用来自欧洲泌尿外科学会（EAU）经皮肾镜取石术全球研究数据库（CROES PCNL 数据库）的前瞻性收集数据。将老年患者定义为年龄 70 岁及以上，而年轻患者为 18 至 70 岁。根据评估结石清除状态所使用的影像学方式进行匹配和非匹配组比较。比较患者特征、手术数据和术后结局。
老年组与年轻组的中位年龄分别为 74 岁（范围 70-93 岁）和 49 岁。在非匹配分析中，老年组鹿角形结石的发生率较高（27.8% vs 21.8%，P=0.014）；然而，平均结石大小无显著差异（465.0 vs 422.8，P=0.063）。非匹配分析中，老年组的住院时间明显长于年轻组（5 天 vs 4.1 天，P<0.001）。在匹配分析中，这种差异并不明显（5.0 天 vs 4.4 天，P=0.288）。非匹配分析中，总体并发症发生率无显著差异。然而，在匹配分析中，总体并发症发生率存在统计学意义的升高。各组的结石清除率相似。
70 岁以上老年患者行 PCNL 的效果与年轻患者相当。尽管并发症发生率略高（尽管具有统计学意义），但老年患者的结石清除率与年轻组相同。
