Perioperative Outcomes of Percutaneous
Nephrolithotomy in Septuagenarians and Beyond
Chinnakhet Ketsuwan MD¹, Charoen Leenanupunth MD¹, Wachira Kochakarn MD¹, Yada Phengsalae MSc¹,
Premsant Sangkum MD¹, Wisoot Kongchareonsombat MD¹
Affiliation : ¹ Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background: Life expectancy has continuously risen worldwide. Because the elderly may tolerate complications poorly, the risks and benefits of
percutaneous nephrolithotomy (PCNL) in those patients should be discussed thoroughly.
Objective: To analyze utility and operative outcomes of PCNL with respect to age.
Materials and Methods: A retrospective study of PCNL was performed at Ramathibodi Hospital between 2011 and 2020. The patients were divided into two age groups, 1) below 70 years old and 2) 70 years old and above. Comparison of demographics, operative data, and postoperative outcomes were analyzed.
Results: Of the 253 patients, the overall stone-free rate (SFR) was 59.7%. The SFR in younger groups and older groups were 59.4% (126/212) and 61.0% (25/41), respectively, which was not significantly different (p=0.999). There was a similar in-stone burden between the two groups (p=0.573). Patients in the older group had worse renal function, higher American Society of Anesthesiologists score, and more comorbidities, including hypertension and ischemic heart disease. However, estimated blood loss, length of hospital stay, operative time, percent change in eGFR, and complications were comparable between the groups.
Conclusion: PCNL is a safe and effective treatment of kidney calculi in septuagenarians and older patients, even with the risk of higher comorbidities and poorer renal function than in younger patients.
Received 5 April 2021 | Revised 23 July 2021 | Accepted 23 July 2021
doi.org/10.35755/jmedassocthai.2021.09.12781
Keywords :
Percutaneous nephrolithotomy; Renal calculus; Stone-free status; Septuagenarians
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