2012

Yaşlı hastalarda perkütan nefrolitotominin etkinliği ve güvenilirliği: 128 vaka deneyimi

AMAÇ: Bu çalışmada böbrek taşı > 2 cm olan yaşlı hastalarda (≥65 yaş) perkütan nefrolitotominin etkinlik ve güvenilirliğinin değerlendirilmesi amaçlanmıştır. HASTALAR VE YÖNTEM: Ocak 2015 ile Ocak 2022 tarihleri arasında böbrek taşı nedeniyle perkütan nefrolitotomi uygulanan 65 yaş ve üzeri hastalar bu çalışmaya dahil edildi. Hasta profilleri, ameliyat öncesi taş verileri, ameliyat bilgileri ve ameliyat sonrası komplikasyonlar gözden geçirildi. Perkütan nefrolitotominin net sonuçlarını tahmin etmek için Guys Stone skorunu uyguladık. BULGULAR: 128 geriatrik hastaya perkütan nefrolitotomi uygulandı. Bu hastaların 68'i (%53,1) erkek, 60'ı (%46,9) kadındı. Ortalama yaş 69.87 ± 7.06 (65-80) yıldı. Ortalama taş boyutu 28.7 ± 6.5 mm (22-46 mm) idi. Ortalama ameliyat süresi 90.33 ± 40.56 dk ve floroskopi süresi 5.16 ± 2.81 dk idi. Yeniden giriş kateteri ortalama 3.21 ± 1.82 gün sonra çıkarıldı. Ortalama hastanede kalış süresi 3.17 ± 2.19 gündü. Taşsız sağkalım oranı %90.6 idi. Dört hastada (%3.1) kanama nedeniyle transfüzyon yapıldı ve sekiz hastada (%6.2) yeniden giriş yolundan idrar ekstravazasyonu meydana geldi ve bu, Double j-stent yerleştirilmesini gerektirdi. Dört Guys taş skor grubu karşılaştırıldığında, taşsızlık oranlarında istatistiksel olarak anlamlı bir fark vardı (p = 0.001). SONUÇ: Sonuçlarımıza göre, perkütan nefrolitotomi, yaşlılarda nefrolitiazis için yüksek taşsızlık ve kabul edilebilir komplikasyon oranları ile güvenli ve etkili bir tedavi seçeneğidir.

Anahtar Kelimeler:

yaşlı hastalar, perkütan nefrolitotomi, nefrolitiazis, Guys taş skoru

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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