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Liu J, Gu J, Xu W, Tian C, Pang D, Zhang N, Liu Y, Yang B, Huang X. Efficacy and safety of percutaneous nephrolithotripsy in elderly patients: a retrospective study. BMC Surg 2022; 22:392. [DOI: 10.1186/s12893-022-01830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Percutaneous nephrolithotripsy (PCNL) is difficult to perform for elderly patients; thus, this study aimed to assess its efficacy and safety in elderly patients aged > 70 years, note any associations between outcomes and patient characteristics, and summarize relevant themes and observations.
Methods
Data from patients older than 70 years who had undergone PCNL for upper urinary tract calculi between January 2016 and January 2021 was retrospectively analyzed. Risk factors for postoperative complications and residual stones were analyzed using multivariate logistic regression.
Results
A total of 116 elderly patients underwent 122 PCNL operations, of which six underwent secondary PCNL operations, and all of which were successfully completed. The average age was 74.6 ± 4.3 years; the average stone size and operation time were 3.5 ± 1.8 (1.2–11 cm), and 71.8 ± 34.1 min, respectively. Of the participants, 16 or 13.8% had postoperative complications and 29 (25%) had residual stones after operation. The stone free rate was 75%. Multivariate analysis revealed that an American Score of Anesthesiology III was an independent risk factor for postoperative complications (odds ratio [OR] = 4.453, p = 0.031), and staghorn calculi were independent risk factors for postoperative residual calculi (OR = 31.393, p = 0.001).
Conclusion
PCNL was shown to be safe and effective for elderly patients aged > 70 years. Further, ASA III was an independent risk factor for postoperative complications, and staghorn calculi were independent risk factors for postoperative residual calculi in elderly patients.
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Hong Y, Wang H, Xu Q, Chen L, Huang X, Xiong L. Mini-track, mini-nephroscopy, mini-ultrasonic probe percutaneous nephrolithotomy and its initial clinical application. BMC Urol 2022; 22:144. [PMID: 36071397 PMCID: PMC9450233 DOI: 10.1186/s12894-022-01061-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background To assess the outcome of the mini-track, mini-nephroscopy, mini ultrasonic probe percutaneous nephrolithotomy for upper ureteral and kidney stones. Methods We collected data of 53 patients (55 kidney units) who underwent mini-track, mini-nephroscopy, mini-ultrasonic probe percutaneous nephrolithotomy between September 2020 and March 2021. The study included single and upper ureteral stones from 12 kidneys, multiple stones from 28 kidneys, and staghorn stones from 15 kidneys. Results The mean operative duration was 50.6 min, ranging from 15 to 200 min, whereas the mean lithotripsy and stone removal time was 17.2 min (3–45 min). Moreover, the mean postoperative length of stay was 4.0 days (1–7 days). Besides, the stone-free rate (SFR) of discharge was 89.1% (49/55). The mean hemoglobin drop was 15.3 mg/dL, ranging 1–32 mg/dL. Out of the total cases, only 4 of them displayed minor complications. The outcomes of < 40 mm versus ≥ 40 mm calculi were compared by performing subgroup analysis. The results demonstrated a longer operation duration (65.2 vs. 40.2 min), higher complication rate (13.0% vs. 3.3%), and lower SFR in the ≥ 40 mm calculi subgroup. Conclusions In summary, mini-track, mini-nephroscopy, mini-ultrasonic probe percutaneous nephrolithotomy is an effective and safe method to treat patients with upper ureteral and kidney calculi. This is especially significant for the stone size of 20–40 mm, demonstrating excellent SFR and a lower complication rate.
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Affiliation(s)
- Yang Hong
- The Department of Urology, Peking University People's Hospital, 11# Xizhimen Nandajie Street, XiCheng District, Beijing, 100034, China.,Peking University Applied Lithotripsy Institute, Beijing, China
| | - Huanrui Wang
- The Department of Urology, Peking University People's Hospital, 11# Xizhimen Nandajie Street, XiCheng District, Beijing, 100034, China.,Peking University Applied Lithotripsy Institute, Beijing, China
| | - Qingquan Xu
- The Department of Urology, Peking University People's Hospital, 11# Xizhimen Nandajie Street, XiCheng District, Beijing, 100034, China.,Peking University Applied Lithotripsy Institute, Beijing, China
| | - Liang Chen
- The Department of Urology, Peking University People's Hospital, 11# Xizhimen Nandajie Street, XiCheng District, Beijing, 100034, China.,Peking University Applied Lithotripsy Institute, Beijing, China
| | - Xiaobo Huang
- The Department of Urology, Peking University People's Hospital, 11# Xizhimen Nandajie Street, XiCheng District, Beijing, 100034, China. .,Peking University Applied Lithotripsy Institute, Beijing, China.
| | - Liulin Xiong
- The Department of Urology, Peking University People's Hospital, 11# Xizhimen Nandajie Street, XiCheng District, Beijing, 100034, China. .,Peking University Applied Lithotripsy Institute, Beijing, China.
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