İbrahim Güven KARTAL, Okan ALKIŞ, Bekir ARAS, Mehmet SEVİM, Oğuzhan Yusuf SÖNMEZ

YAŞLILARDA PERKÜTAN NEFROLİTOTOMİNİN ETKİNLİĞİ

AMAÇ: Bu çalışmanın amacı yaşlılarda perkütan nefrolitotominin (PNL) güvenliliğini ve etkinliğini araştırmaktır. GEREÇ VE YÖNTEM: Ocak 2015- Ocak 2020 arasında perkütan nefrolitotomi uygulanan 238 hastanın verileri geriye dönük olarak incelendi. Toplam 238 hasta 86’sı yaşlı (65 yaş üstü) ve 152’si genç (65 yaş altı) olmak üzere iki gruba ayrıldı. 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 %95 CI=0,012-0,377) yaşlı hastalarda komplikasyonlarla ilişkili bulundu. SONUÇ: Perkütan nefrolitotomi yaşlı hastalarda güvenle ve yüksek başarı ile uygulanabilir. Taş sayısı ve yükü fazla olan geriatrik hastalarda PNL için komplikasyon riskinin arttığı unutulmamalıdır.

EFFICACY OF PERCUTANEOUS NEPHROLITHOTOMY IN THE ELDERLY

AIM: This study aims to investigate the safety and efficacy of percutaneous nephrolithotomy (PNL) in the elderly. Material and Method: The data of 238 patients who underwent PNL between January 2015 and January 2020 were retrospectively analyzed. A total 238 patients were divided into two groups made up of 86 elderly (above 65 years old) and 152 non-elderly persons (under 65 years old). Demographic data, stone characteristics, operation data, and complications were compared between the elderly and non-elderly 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 non-elderly (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 95% 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.

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