University Hospital Southampton, NHS Trust, United Kingdom, UK.
Int Braz J Urol. 2018 Jul-Aug;44(4):750-757. doi: 10.1590/S1677-5538.IBJU.2017.0516.
To assess outcomes of ureteroscopy for treatment of stone disease in the elderly. Ureteroscopy (URS) is an increasingly popular treatment modality for urolithiasis and its applications are ever expanding with the development of newer technologies. Its feasibility and outcomes within the elderly population to our knowledge remain under-reported.
We examined the patient demographics and surgical outcomes from our prospective database for patients ≥70 years who underwent URS for urolithiasis, in a 5-year period between March 2012 and December 2016.
A total of 110 consecutive patients underwent 121 procedures (1.1 procedure/ patient) with a mean age of 77.2 years (range: 70-91 years). Stone location was in the kidney/ pelviureteric junction (PUJ) in 29%, ureter in 37% and in multiple locations in 34%. The initial and final stone free rate (SFR) was 88% and 97% respectively. While 73% were done as true day case procedures, 89% patients were discharged within 24 hours. Eleven patients (9%) underwent complications of which 10 were Clavien I/II including acute urinary retention, urinary tract infection, stent symptoms and pneumonia. One patient underwent Clavien IV complication where they needed intensive care unit admission for urosepsis but fully recovered and were discharged home subsequently.
Ureteroscopy is a safe and effective method of managing urolithiasis in elderly patients. Although most patients are discharged within 24-hours, consideration needs to be made for patients where social circumstances can impact their discharge planning.
评估输尿管镜治疗老年结石病的结果。输尿管镜检查（URS）是治疗尿路结石的一种越来越受欢迎的治疗方法，随着新技术的发展，其应用范围不断扩大。据我们所知，其在老年人群中的可行性和结果报告较少。
我们检查了我们的前瞻性数据库中年龄≥70 岁的患者的人口统计学和手术结果，这些患者在 2012 年 3 月至 2016 年 12 月的 5 年期间接受了 URS 治疗尿路结石。
共有 110 例连续患者接受了 121 次手术（1.1 次/例），平均年龄为 77.2 岁（范围：70-91 岁）。结石位置在肾脏/肾盂输尿管连接部（PUJ）占 29%，输尿管占 37%，多个部位占 34%。初始和最终的无结石率（SFR）分别为 88%和 97%。虽然 73%的手术是真正的日间手术，但 89%的患者在 24 小时内出院。11 例（9%）患者发生并发症，其中 10 例为 Clavien I/II 级，包括急性尿潴留、尿路感染、支架症状和肺炎。1 例患者发生 Clavien IV 级并发症，需要入住重症监护病房治疗败血症，但随后完全康复并出院回家。
输尿管镜检查是治疗老年结石病的一种安全有效的方法。尽管大多数患者在 24 小时内出院，但需要考虑那些社会环境可能影响其出院计划的患者。
