Supine percutaneous nephrolitotripsy in septuagenarian and octogenarian patients: outcomes of a case-control study
Currently, there is a paucity of data evaluating the outcomes of supine percutaneous nephrolithotomy (PCNL) in septuagenarian and octogenarian patients. In this study we aim to compare the outcomes of supine PCNL in elderly patients with those of younger population.
A matched case-control study was performed from January 2009 through December 2015 using our prospectively collected kidney stone database. Case group was composed of patients with age greater than 70 years. Control group included patients with less than 70 years old. Patients were randomly matched based on Guys Stone Score as a surrogate of case complexity.
Fifty-four patients were enrolled in this study, 18 cases and 36 controls. Cases were significantly older than controls (p<0.001). There were no significant differences in gender and body mass index between groups. There were significantly more ASA 3 patients in septuagenarian and octogenarian patients (p=0.012). Regarding PCNL technique, there were no differences in number of accesses, number of supra-costal accesses, and operative time. There was no significant difference in stone-free rate, nephrostomy tube time, complication rate, mean decrease in hemoglobin level, and need of blood transfusion. Hospital stay time (days) was longer in case group (4.0 vs. 2.4 days; p=0.002). Table 1 summarizes perioperative data, while table 2 shows postoperative complications according to Clavien score.</p>
Septuagenarian and octogenarian patients have similar complication and stone-free rates compared to younger patients, although they demand a longer length of hospital stay.