Yavuz Tarık ATIK, Hacı İ. ÇİMEN, Deniz GÜL, Safa ARSLAN, Fikret HALİS

Perkütan Nefrolitotomi Yaşlı Hastalarda Korkutucu Değildir: Tek Merkez Sonuçları

Amaç: PNL operasyonu uygulanan 70 yaş üstü hastaların postoperatif sonuçlarını değerlendirmek ve daha gençı hastalar ile karşılaştırmak. Gereç ve Yöntemler: Kurumumuzda 2016-2019 yılları arasında 2 cm'den büyük böbrek taşı için konvansiyonel PNL operasyonu uygulanan 508 hastanın verisini retrospektif olarak değerlendirdik. Hastalar yaşlarına göre iki gruba ayrıldı. 70 yaş ve üstü hastalar grup 2, 70 yaşından küçük hastalar grup 1 olarak ayrıldı. Gruplar arasında hastaların komorbiditeleri, ASA skorları, vücut kitle indeksleri (VKİ), taş boyutu gibi demografik verileri ve ameliyat süresi, floroskopi süresi, komplikasyon oranı, hastanede kalış süresi ve taşsızlık oranı gibi perioperatif ve postoperatif değerleri karşılaştırıldı. Bulgular: Grup 1'de 476 hasta, Grup 2'de 32 hasta mevcuttu. Ortalama yaş, yaşlı hasta grubunda 73 (70-86), genç hasta grubunda 48 (18-69) idi. Gruplar arasında multipl taş oranı, operasyon süresi, floroskopi süresi, hastanede kalış süresi, taşsızlık oranı ve komplikasyon oranları açısından fark yoktu. Ameliyat öncesi taş büyüklüğü, staghorn taş oranı ve transfüzyon oranı yaşlı hastalarda genç gruba göre anlamlı olarak yüksekti (sırasıyla; p = 0.027, 0.009, 0.003). Sonuç: PNL, büyük böbrek taşına sahip yaşlı hastalarda kabul edilebilir sonuçlara sahiptir ve güvenle uygulanabilir.

Anahtar Kelimeler:

böbrek taşı, güvenli, nefrolitotomi, perkütan, yaşlı

Percutaneous Nephrolithotomy is not Frightening in Elderly Patients: A Single Center Outcomes

Objective: To evaluate the operative and postoperative outcomes in patients >70 years of age who underwent PNL and to compare them with a younger group. Materila and Methods: We retrospectively evaluated 508 patient data who underwent conventional PNL for >2 cm kidney stones in our institution between 2016 and 2019. The patients were divided in to two group according to their age. Group 1 consisted with patient whose age is younger than 70 years and Group 2 consisted with patient whose age is equal or higher than 70 years. Patients’ comorbidities, ASA scores, body mass indices (BMI), stone size and perioperative values such as surgery time, fluoroscopy time, complication rates, length of hospital stay and stone-free rates were compared between the groups. Results: 476 patients were identified in Group 1 (younger), and 32 patients were in Group 2 (elderly). The mean age in elderly patients was 73 years (range 70-86) and 48 years (range 18-69) in younger group. There is no difference in multiple stone rate, operation time, fluoroscopy time, length of hospital stay, the levels of stone free rate and complication rates between groups. Preoperative stone size, staghorn stone rate, and transfusion rate was significantly higher in elderly patients than younger group (respectively; p = 0.027, 0.009, 0.003). Conclusion: PNL had acceptable results for large kidney stones and was safe in elderly patients.

Keywords:

elderly, kidney stone, nephrolithotomy, percutaneous, safety,

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