Influence of Aging in Outcomes of Patients Undergoing Percutaneous
Nephrolithotomy for Staghorn Stones : A retrospective comparative study
Abstract
Objective: To evaluate the effect of age on the success and
complications of percutaneous nephrolithotomy (PCNL) in staghorn renal
stones. Materials and Methods: The files of 182 patients who underwent
single-access PCNL for 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: Of the patients with 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 for Group-1 and 67.8±2.1 years for
Group-2(p=0.001). The amount of hemoglobin drop was statistically
significantly higher in Group-1 (p=0.001). However, blood transfusion
rate was higher in Group-2 than in Group-1 (18.6% and 7.2%,
respectively). The stone-free rate was 54.7% in Group-1 and 67.4% in
Group-2(p=0.139). According to 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 statistically
higher in the elderly patient group (p=0.019). Conclusions: PCNL can be
used as an effective and safe treatment method in the treatment of
complex stones in elderly patients.