Abstract
Objective: To evaluate the effect of age on the success and
complications of percutaneous nephrolithotomy(PCNL) in staghorn renal
stones. Material 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 of the
patients were compared between the two groups.Postoperative detection of
stones>4 mm was defined as residual stones.Complications
were classified according to the Clavien scoring system. 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 mean stone size in Group-1
and Group-2 was 899±292 and 1,008±208 mm2, respectively(p=0.736). When
we evaluated the postoperative results, we observed that the amount of
hemoglobin drop was statistically significantly higher in
Group-1(p=0.001). However, the need for blood transfusion 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). When we examined the subgroups of complications
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). Conclusion: PCNL can be used as an effective and safe
treatment method in the treatment of complex stones in elderly patients