The Influence of Aging on Outcomes in Patients Undergoing Percutaneous Nephrolithotomy for Complete Staghorn Stones: A Retrospective Comparative Study.

Abstract

ObjectiveIn this study, we aimed to evaluate the effect of age on the success and complications of percutaneous nephrolithotomy (PCNL) for complete staghorn renal stones.Materials and methodsThe files of 182 patients who underwent single-access PCNL for complete staghorn renal stones between 2012 and 2017 were retrospectively analyzed. The patients were divided into two groups according to their age: those aged <65 years were defined as Group-1 and those aged ≥65 years as Group-2. The demographic characteristics and perioperative and postoperative results were compared between the two groups.ResultsAmong the patients with complete staghorn renal stones, 139 were in Group-1 and 43 were in Group-2. The mean age of the patients was 43.9 ±10.6 years in Group-1 and 67.8 ±2.1 years in Group-2 (p=0.001). The rate of hemoglobin drop was significantly higher in Group-1 (p=0.001). However, the blood transfusion rate was higher in Group-2 than in Group-1 (18.6% vs. 7.2%, respectively). The stone-free rate was 54.7% in Group-1 and 67.4% in Group-2 (p=0.139). As for the evaluation of the overall complication rates, 34.5% of the patients in Group-1 and 46.5% of those in Group-2 developed complications (p=0.206).According to the Clavien scoring system, the rate of minor complications was found to be 22.3% in Group-1 and 41.9% in Group-2, and the difference was statistically significant (p=0.012). The major complication rates were determined as 4.7% and 12.2% for Group-1 and Group-2, respectively (p=0.155). The number of patients with Clavien grade-2 complications was significantly higher in the elderly patient group (p=0.019).ConclusionsBased on our findings, PCNL is an effective and safe method in the treatment of complete staghorn stones in elderly patients.