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Geriatrik Hastalarda Perkütan Nefrolitotominin Güvenilirliğinin ve Komplikasyonları Etkileyen Faktörlerin Değerlendirilmesi

Year 2021, Volume: 54 Issue: 2, 307 - 312, 31.08.2021
https://doi.org/10.20492/aeahtd.931349

Abstract

Amaç: Bu çalışmanın amacı yaşlılarda perkutan nefrolitotominin (PNL) güvenliliğini ve etkinliğini araştırmaktır.
Yöntem: Perkutan nefrolitotomi uygulanan 238 hastanın verileri geriye dönük olarak incelendi. Hastalar iki gruba ayrıldı (yaşlı:> 65, genç:<65 yaş). Demografik veriler, taş özellikleri, operasyon verileri ve komplikasyonlar gruplar arasında karşılaştırıldı.
Bulgular: Çalışmaya 86 (% 36,1) yaşlı hasta dahil edildi. Demografik özellikler, başarı ve komplikasyon oranları açısından gruplar arasında anlamlı fark yoktu (p>0.05). Genelde taşsızlık oranı yaşlılarda % 86,0, genç hastalarda %86,8 idi (p>0.05). Çok değişkenli analizde; taş boyutu (p=0,032, OR=0,202 ve %95 CI=0.047-0.873) ve taş sayısı (p=0,002, OR=0,067 ve CI=0,012-0,377) yaşlı hastalarda komplikasyonlarla ilişkili bulundu.
Sonuç: Perkutan nefrolitotomi yaşlı hastalarda güvenle ve yüksek başarı ile uygulanabilir. Taş sayısı ve yükü fazla olan geriatrik hastalarda PNL için komplikasyon riskinin arttığı unutulmamalıdır.

References

  • 1. Wollin DA, Preminger GM. Percutaneous nephrolithotomy: complications and how to deal with them. Urolithiasis. 2018;46(1):87-97.
  • 2. World Health Organization. Psychogeriatrics. Report of a WHO scientific group. World Health Organ Tech Rep Ser 1972;507:1-48. Available at: https://pubmed.ncbi.nlm.nih.gov/4627568/. Accessed 20.10.2020
  • 3. Akman T, Binbay M, Ugurlu M, et al. Outcomes of retrograde intrarenal surgery compared with percutaneous nephrolithotomy in elderly patients with moderate-size kidney stones: a matched-pair analysis. J Endourol. 2012;26(6):625-9.
  • 4. Beard JR, Officer A, de Carvalho IA, et al. The World report on aging and health: a policy framework for healthy aging. Lancet. 2016;387(10033):2145-54.
  • 5. Muslumanoglu AY, Binbay M, Yuruk E, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res. 2011;39(4):309-14.
  • 6. Şahin S, Ertoğral O, Yarıcı MA. Türkiye’de 3 Yaş Grubu Nüfusun İllere Göre Değişiminin Coğrafi Bilgi Sistemleri İle Analizi. Journal of International Scientific Researches. 2019;4(2):292-304.
  • 7. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-13.
  • 8. Sighinolfi MC, Micali S, Grande M, et al. Extracorporeal shock wave lithotripsy in an elderly population: how to prevent complications and make the treatment safe and effective. J Endourol. 2008;22(10):2223-6.
  • 9. Gokcen K, Dundar G, Bagcioglu M, et al. Safety and Efficacy of RIRS in Geriatric Patients: A Comparative Evaluation on an Age Based Manner. Urol J. 2020;17(2):129-33.
  • 10. Abedali ZA, Large T, Heiman JM, et al. Percutaneous Nephrolithotomy in the 80 Years of Age and Older Population. Urology. 2019;134:62-5.
  • 11. Sahin A, Atsu N, Erdem E, et al. Percutaneous nephrolithotomy in patients aged 60 years or older. J Endourol. 2001;15(5):489-91.
  • 12. Karami H, Mazloomfard MM, Golshan A, et al. Does age affect outcomes of percutaneous nephrolithotomy? Urol J. 2010;7(1):17-21.
  • 13. Turk C, Petrik A, Sarica K, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016;69(3):475-82.
  • 14. Haider R, Regnier P, Roustan FR, et al. (Percutaneous nephrolithotomy for kidney stones in elderly patients: Meta-analysis of results and complications). Prog Urol. 2017;27(2):58-67.
  • 15. Anagnostou T, Thompson T, Ng CF, et al. Safety and outcome of percutaneous nephrolithotomy in the elderly: retrospective comparison to a younger patient group. J Endourol. 2008;22(9):2139-45.
  • 16. Buldu I, Tepeler A, Karatag T, et al. Does aging affect the outcome of percutaneous nephrolithotomy? Urolithiasis. 2015;43(2):183-7.
  • 17. Huang WY, Wu SC, Chen YF, et al. Surgeon volume for percutaneous nephrolithotomy is associated with medical costs and length of hospital stay: a nationwide population-based study in Taiwan. J Endourol. 2014;28(8):915-21.
  • 18. Haberal HB, Gudeloglu A, Deger M, et al. Percutaneous Nephrolithotomy in Young-Old, Old-Old, and Oldest-Old Patients: a Multicenter Study. J Laparoendosc Adv Surg Tech A. 2020.
  • 19. Okeke Z, Smith AD, Labate G, et al. Prospective comparison of outcomes of percutaneous nephrolithotomy in elderly patients versus younger patients. J Endourol. 2012;26(8):996-1001.
  • 20. Knoll T, Daels F, Desai J, et al. Percutaneous nephrolithotomy: technique. World J Urol. 2017;35(9):1361-8.
  • 21. Tefekli A, Ali Karadag M, Tepeler K, et al. Classification of percutaneous nephrolithotomy complications using the modified clavien grading system: looking for a standard. Eur Urol. 2008;53(1):184-90.
  • 22. Dikicier E , Kamburoğlu M , Gönüllü E , et al. Surgical outcomes in elderly patients with obstructed colorectal cancer: Single center experience. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53(3): 196-201.
  • 23. Un S, Cakir V, Kara C, et al. Risk factors for hemorrhage requiring embolization after percutaneous nephrolithotomy. Can Urol Assoc J. 2015;9(9-10):E594-8.
  • 24. Meng X, Bao J, Mi Q, et al. The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy. Biomed Res Int. 2019;2019:8619460.
  • 25. Rashid AO, Fakhulddin SS. Risk factors for fever and sepsis after percutaneous nephrolithotomy. Asian J Urol. 2016;3(2):82-7.

Evaluation of Safety and Factors Affecting Complications of Percutaneous Nephrolithotomy in Elderly

Year 2021, Volume: 54 Issue: 2, 307 - 312, 31.08.2021
https://doi.org/10.20492/aeahtd.931349

Abstract

Purpose: This study aims to investigate the safety and efficacy of percutaneous nephrolithotomy (PNL) in the elderly.
Methods: The data of 238 patients who underwent PNL were retrospectively analyzed. The patients were divided into two groups (elderly: >65). Demographic data, stone characteristics, operation data, and complications were compared between the elderly and younger patients.
Results: Eighty-six (36.1%) elderly patients were included in the study. There was no significant difference between the groups in terms of demographic characteristics, success, and complication rates (p>0.05). The overall stone-free rate was 86.0% in the elderly and 86.8% in young patients (p>0.05). In multivariable analysis; stone size (p=0.032, OR=0.202 and %95 CI=0.047-0.873) and number of stones (p=0.002, OR=0.067 and CI=0.012-0.377) were found to be associated with complications in elderly.
Conclusion: Percutaneous Nephrolithotomy can be performed safely with high success in elderly patients. It should be kept in mind that the risk of complications for PNL is increased in geriatric patients with a high number of stones and burden.

References

  • 1. Wollin DA, Preminger GM. Percutaneous nephrolithotomy: complications and how to deal with them. Urolithiasis. 2018;46(1):87-97.
  • 2. World Health Organization. Psychogeriatrics. Report of a WHO scientific group. World Health Organ Tech Rep Ser 1972;507:1-48. Available at: https://pubmed.ncbi.nlm.nih.gov/4627568/. Accessed 20.10.2020
  • 3. Akman T, Binbay M, Ugurlu M, et al. Outcomes of retrograde intrarenal surgery compared with percutaneous nephrolithotomy in elderly patients with moderate-size kidney stones: a matched-pair analysis. J Endourol. 2012;26(6):625-9.
  • 4. Beard JR, Officer A, de Carvalho IA, et al. The World report on aging and health: a policy framework for healthy aging. Lancet. 2016;387(10033):2145-54.
  • 5. Muslumanoglu AY, Binbay M, Yuruk E, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res. 2011;39(4):309-14.
  • 6. Şahin S, Ertoğral O, Yarıcı MA. Türkiye’de 3 Yaş Grubu Nüfusun İllere Göre Değişiminin Coğrafi Bilgi Sistemleri İle Analizi. Journal of International Scientific Researches. 2019;4(2):292-304.
  • 7. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-13.
  • 8. Sighinolfi MC, Micali S, Grande M, et al. Extracorporeal shock wave lithotripsy in an elderly population: how to prevent complications and make the treatment safe and effective. J Endourol. 2008;22(10):2223-6.
  • 9. Gokcen K, Dundar G, Bagcioglu M, et al. Safety and Efficacy of RIRS in Geriatric Patients: A Comparative Evaluation on an Age Based Manner. Urol J. 2020;17(2):129-33.
  • 10. Abedali ZA, Large T, Heiman JM, et al. Percutaneous Nephrolithotomy in the 80 Years of Age and Older Population. Urology. 2019;134:62-5.
  • 11. Sahin A, Atsu N, Erdem E, et al. Percutaneous nephrolithotomy in patients aged 60 years or older. J Endourol. 2001;15(5):489-91.
  • 12. Karami H, Mazloomfard MM, Golshan A, et al. Does age affect outcomes of percutaneous nephrolithotomy? Urol J. 2010;7(1):17-21.
  • 13. Turk C, Petrik A, Sarica K, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol. 2016;69(3):475-82.
  • 14. Haider R, Regnier P, Roustan FR, et al. (Percutaneous nephrolithotomy for kidney stones in elderly patients: Meta-analysis of results and complications). Prog Urol. 2017;27(2):58-67.
  • 15. Anagnostou T, Thompson T, Ng CF, et al. Safety and outcome of percutaneous nephrolithotomy in the elderly: retrospective comparison to a younger patient group. J Endourol. 2008;22(9):2139-45.
  • 16. Buldu I, Tepeler A, Karatag T, et al. Does aging affect the outcome of percutaneous nephrolithotomy? Urolithiasis. 2015;43(2):183-7.
  • 17. Huang WY, Wu SC, Chen YF, et al. Surgeon volume for percutaneous nephrolithotomy is associated with medical costs and length of hospital stay: a nationwide population-based study in Taiwan. J Endourol. 2014;28(8):915-21.
  • 18. Haberal HB, Gudeloglu A, Deger M, et al. Percutaneous Nephrolithotomy in Young-Old, Old-Old, and Oldest-Old Patients: a Multicenter Study. J Laparoendosc Adv Surg Tech A. 2020.
  • 19. Okeke Z, Smith AD, Labate G, et al. Prospective comparison of outcomes of percutaneous nephrolithotomy in elderly patients versus younger patients. J Endourol. 2012;26(8):996-1001.
  • 20. Knoll T, Daels F, Desai J, et al. Percutaneous nephrolithotomy: technique. World J Urol. 2017;35(9):1361-8.
  • 21. Tefekli A, Ali Karadag M, Tepeler K, et al. Classification of percutaneous nephrolithotomy complications using the modified clavien grading system: looking for a standard. Eur Urol. 2008;53(1):184-90.
  • 22. Dikicier E , Kamburoğlu M , Gönüllü E , et al. Surgical outcomes in elderly patients with obstructed colorectal cancer: Single center experience. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53(3): 196-201.
  • 23. Un S, Cakir V, Kara C, et al. Risk factors for hemorrhage requiring embolization after percutaneous nephrolithotomy. Can Urol Assoc J. 2015;9(9-10):E594-8.
  • 24. Meng X, Bao J, Mi Q, et al. The Analysis of Risk Factors for Hemorrhage Associated with Minimally Invasive Percutaneous Nephrolithotomy. Biomed Res Int. 2019;2019:8619460.
  • 25. Rashid AO, Fakhulddin SS. Risk factors for fever and sepsis after percutaneous nephrolithotomy. Asian J Urol. 2016;3(2):82-7.
There are 25 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original research article
Authors

Okan Alkış 0000-0001-6116-9588

İbrahim Kartal 0000-0002-2313-3522

Bekir Aras 0000-0002-7020-8830

Mehmet Sevim 0000-0002-7571-7669

Oğuzhan Yusuf Sönmez 0000-0003-1538-867X

Publication Date August 31, 2021
Submission Date May 2, 2021
Published in Issue Year 2021 Volume: 54 Issue: 2

Cite

AMA Alkış O, Kartal İ, Aras B, Sevim M, Sönmez OY. Evaluation of Safety and Factors Affecting Complications of Percutaneous Nephrolithotomy in Elderly. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. August 2021;54(2):307-312. doi:10.20492/aeahtd.931349