Sahan Murat, Yarımoğlu Serkan, Savun Metin, Erdemoglu Onur, Degirmenci Tansu
Urology, University of Health Sciences İzmir Bozyaka Education and Research Hospital, Izmir, TUR.
Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, TUR.
Cureus. 2021 Nov 29;13(11):e20001. doi: 10.7759/cureus.20001. eCollection 2021 Nov.
Objective In this study, we aimed to evaluate the effect of age on the success and complications of percutaneous nephrolithotomy (PCNL) for complete staghorn renal stones. Materials and methods The files of 182 patients who underwent single-access PCNL for complete staghorn renal stones between 2012 and 2017 were retrospectively analyzed. The patients were divided into two groups according to their age: those aged <65 years were defined as Group-1 and those aged ≥65 years as Group-2. The demographic characteristics and perioperative and postoperative results were compared between the two groups. Results Among the patients with complete staghorn renal stones, 139 were in Group-1 and 43 were in Group-2. The mean age of the patients was 43.9 ±10.6 years in Group-1 and 67.8 ±2.1 years in Group-2 (p=0.001). The rate of hemoglobin drop was significantly higher in Group-1 (p=0.001). However, the blood transfusion rate was higher in Group-2 than in Group-1 (18.6% vs. 7.2%, respectively). The stone-free rate was 54.7% in Group-1 and 67.4% in Group-2 (p=0.139). As for the evaluation of the overall complication rates, 34.5% of the patients in Group-1 and 46.5% of those in Group-2 developed complications (p=0.206). According to the Clavien scoring system, the rate of minor complications was found to be 22.3% in Group-1 and 41.9% in Group-2, and the difference was statistically significant (p=0.012). The major complication rates were determined as 4.7% and 12.2% for Group-1 and Group-2, respectively (p=0.155). The number of patients with Clavien grade-2 complications was significantly higher in the elderly patient group (p=0.019). Conclusions Based on our findings, PCNL is an effective and safe method in the treatment of complete staghorn stones in elderly patients.
目的 在本研究中，我们旨在评估年龄对完全鹿角形肾结石经皮肾镜取石术（PCNL）的成功率和并发症的影响。材料与方法 回顾性分析2012年至2017年间接受单通道PCNL治疗完全鹿角形肾结石的182例患者的病历资料。根据年龄将患者分为两组：年龄＜65岁的患者定义为1组，年龄≥65岁的患者定义为2组。比较两组患者的人口统计学特征、围手术期和术后结果。结果 在完全鹿角形肾结石患者中，1组有139例，2组有43例。1组患者的平均年龄为43.9±10.6岁，2组为67.8±2.1岁（p = 0.001）。1组血红蛋白下降率显著更高（p = 0.001）。然而，2组的输血率高于1组（分别为18.6%和7.2%）。1组的结石清除率为54.7%，2组为67.4%（p = 0.139）。至于总体并发症发生率的评估，1组34.5%的患者和2组46.5%的患者发生了并发症（p = 0.206）。根据Clavien评分系统，发现1组轻微并发症发生率为22.3%，2组为41.9%，差异有统计学意义（p = 0.012）。1组和2组的严重并发症发生率分别确定为4.7%和12.2%（p = 0.155）。老年患者组Clavien 2级并发症患者数量显著更多（p = 0.019）。结论 根据我们的研究结果，PCNL是治疗老年患者完全鹿角形结石的一种有效且安全的方法。
