Laparoskopik nefrektomide yatış süresini etkileyen faktörler: Tek Merkez 330 Vaka Deneyimi

Amaç: Bu çalışmamızda laparoskopik nefrektomi yapılan hastalarda yatış süresini etkileyen faktörleri araştırmayı amaçladık. Materyal ve metot: Ocak 2013-Aralık 2021 tarihleri arasında kliniğimizde laparoskopik nefrektomi yapılan hastaların verileri retrospektif olarak incelendi. Hastaların demografik verileri, preoperatif, peroperatif ve postoperatif özellikleri kaydedildi. Çalışmaya dahil edilen hastalar yatış süresi ≤4 gün ve >4 gün olarak iki gruba ayrıldı. Gruplar arasında demografik özellikler, operasyon verileri, peroperatif ve postoperatif komplikasyon durumu univariate analiz ile karşılaştırılarak yatış süresinin uzaması açısından olası risk faktörleri değerlendirildi. Bulgular: Çalışmaya kliniğimizde laparoskopik nefrektomi yapılan 330 hasta dahil edildi. Hastaların 130’u (%39.3) kadın, 200’ü (%60.7) erkek ve ortalama yaşı 50.8±19.7 idi. Hastaların 220’sinin (%66.7) ≤4 gün, 110’unun (%33.3) ise 4 günden uzun yattığı görüldü. Operasyon süresinin uzun olduğu hastalarda yatış süresi de buna paralel olarak uzundu (p

Anahtar Kelimeler:

laparoskopik cerrahi, nefrektomi, komplikasyon, yatış süresi

Efficacy and safety of percutaneous nephrolithotomy in elderly patients: Experience of 128 cases

OBJECTIVE: This study aimed to evaluate the efficacy and safety of percutaneous nephrolithotomy in elderly patients (≥65 years) with kidney stones > 2 cm in size. PATIENTS AND METHODS: Patients aged ≥65 years who underwent percutaneous nephrolithotomy for kidney stones between January 2015 and January 2022 were included in this study. Patient profiles, preoperative stone data, operative information, and postoperative complications were reviewed. We applied the Guys Stone score to predict the net results of percutaneous nephrolithotomy. RESULTS: Percutaneous nephrolithotomy was performed on 128 geriatric patients. Of these patients, 68 (53.1%) were male and 60 (46.9%) were female. The mean age was 69.87 ± 7.06 (65–80) years. The mean stone size was 28.7 ± 6.5 mm (22–46 mm). The mean operative time was 90.33 ± 40.56 min and fluoroscopy time was 5.16 ± 2.81 min. The reentry catheter was removed after an average of 3.21 ± 1.82 days. The mean duration of hospital stay was 3.17 ± 2.19 days. The stone-free survival rate was 90.6%. Transfusion was performed in four (3.1%) patients due to hemorrhage, and urine extravasation from the re-entry tract occurred in eight (6.2%) patients, and this required Double j-stent placement. When the four Guys stone score groups were compared, there was a statistically significant difference in stone-free rates (p = 0.001). CONCLUSIONS: According to our results, percutaneous nephrolithotomy is a safe and effective treatment option for nephrolithiasis in the elderly, with high stone-free and acceptable complication rates.

Keywords:

Elderly patients, percutaneous nephrolithotomy, nephrolithiasis, Guys stone score,

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