Comparison of safety and outcomes of shock wave lithotripsy between elderly and non-elderly patients

Chen, Yi Zhong; Lin, Wun Rong; Lee, Chih Chiao; Sun, Fang; Chow, Yung Chiong; Tsai, Wei Kung; Chiang, Pai Kai; Lin, Ting Po; Chen, Marcelo; Chiu, Allen W.

doi:10.2147/cia.s134750

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…In a retrospective study of 472 diseases conducted by Gokce et al, no difference was found between age groups and success rates of SWL (6). In a study by Chen et al, the SFR in elderly patients were found similar to that of non-elderly patients (41.1% vs 46.5%) (12). In our study, both SFR and CIRF rate among age groups were similar.…”

Section: Discussionsupporting

confidence: 81%

“…The fact that the parameters in the evaluation of treatment success such as different age groups (> 60 years, ≥ 65 years and >/≥ 70 years) definition of success (stone-free, stone-free plus CIRF), definition of CIRF (≤ 2 mm and ≤ 4 mm), time to evaluate success (1 month, 3 months) and evaluation method of treatment result (one or more of KUB graphy, US, CT) are not homogeneous makes it difficult to comment on this issue (6, 8, 10, 12-15). Chen et al found that the rate of retreatment in elderly patients who received SWL for kidney stones was similar to that of non-elderly patients (38.6% vs 42.9%, p = 0.485) (12). In our study, this rate was 27.2% and there was no statistically significant difference between the other age groups.…”

Section: Discussionsupporting

confidence: 63%

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Clinical results of shock wave lithotripsy treatment in elderly patients with kidney stones: Results of 1433 patients

Özer

Tekin

2020

Arch Ital Urol Androl

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Objective: In this study, it was aimed to evaluate the efficacy and safety of SWL treatment in elderly patients with kidney stones. Materials and methods: Data from a total of 3024 patients who underwent SWL treatment for urinary tract stone disease in three centers of our university were evaluated retrospectively. A total of 1433 patients in the adult age group treated for single kidney stones were included in the study. The patients were divided into 3 groups (18-40, 41-64 and ≥ 65) years depending on their age. Demographic data, stone parameters, stone-free rate (SFR) and clinically insignificant residual fragment (CIRF) rate, number of SWL sessions and complication rate were analyzed according to the age groups. Results: The mean age of the patients was 47.38 ± 13.24 years. Stone size was significantly lower in the 18-40 years age group compared to other groups (p = 0.000) and the stones were mostly located on the right side in this age group (p = 0.007). There was no significant relationship between age groups and gender, stone localization, and number of SWL sessions. The overall SFR was 66.4%. Although the SFR was lower (61.4%) and the rate of multiple sessions (27.2%) was higher in ≥ 65 years group, there was no statistically significant difference between age groups regarding SFR, CIRF, need for additional sessions, and complication rates. Conclusions: Due to its similar clinical results, treatment of SWL should not be ignored as a treatment option in the geriatric patient group with kidney stones.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 63%

Clinical results of shock wave lithotripsy treatment in elderly patients with kidney stones: Results of 1433 patients

Özer

Tekin

2020

Arch Ital Urol Androl

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“…One study has shown comparable outcomes for ESWL in appropriately selected patients based on stone size and position in those 65 years and older compared with younger patients. 16 In our case series there was a stone-free rate of 68.3%. Other studies evaluating the stone-free rate after ureterorenoscopy in the elderly, which varied from patients over the age of 60 years in some studies to over 70 years in others, found stone-free rates between 65.8% and 97%.…”

Section: Discussionmentioning

confidence: 44%

“…One study has shown comparable outcomes for ESWL in appropriately selected patients based on stone size and position in those 65 years and older compared with younger patients. 16…”

Section: Discussionmentioning

confidence: 99%

Surgical management of urolithiasis in octogenarians

Whiting

Arican

Farrag

et al. 2019

Journal of Clinical Urology

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Objective: The objective of this study was to report the outcomes of octogenarians undergoing surgical treatment for urolithiasis. Materials and methods: We performed a retrospective review of patients aged over 80 years who underwent surgical management for urolithiasis over 8.5 years. Data was collected for patient demographics, procedure, stone size, position, composition and clearance, urine cultures, complications and length of stay. Results: Sixty patients had 111 surgical procedures: 89 elective procedures (80.2%) and 22 emergency procedures (19.8%). Median age was 83 years (81–85), ASA grade 3 and stone size 8 mm (6–10). Clinical presentation was varied, with only 17 patients (28.3%) presenting with ureteric colic/flank pain. Ureterorenoscopy was performed in 74 procedures (66.7%). A ureteric stent was left in 91 procedures (82.0%). The median length of stay for the emergency patients was 6 nights (3–9.5 nights) and for the elective patients was 1 night (1–3 nights). The complication rate varied depending on the primary procedure performed. The overall complication rate was 19.8%: three (2.7%) Clavien I (urinary retention); 11 (9.9%) Clavien II (blood transfusion/urinary tract infection/urosepsis); two (1.8%) Clavien IIIb (stent insertion/bleeding); three (2.7%) Clavien IV (urosepsis) and three (2.7%) Clavien V (two patients urosepsis and one patient pneumonia). The stone-free rate was 68.3%. Conclusion: Octogenarian patients with urolithiasis have a variable presentation, and in patients with sepsis of unknown origin urolithiasis should be considered. We demonstrate that surgical treatment, in particular ureterorenoscopy, can be safely and effectively performed in octogenarians with appropriate surgical planning. Level of evidence: 4 Case series

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“…And the SFR of ESWL for obese patients is also greatly reduced ( 16 ). It is reported that, in comparison with the non-senile group treated by ESWL, there was no significant difference in SFR in senile group ( 17 ). However, the incidence of complications was higher in senile group than that in non-senile group.…”

Section: Discussionmentioning

confidence: 91%

Flexible ureteroscopic holmium laser lithotripsy with PolyScope for senile patients with renal calculi

Ding

Shi

et al. 2018

Exp Ther Med

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The present study reported the clinical experience of using a PolyScope with holmium laser lithotripter in managing renal calculi in senile patients. Between December 2013 and December 2016, 157 senile patients (69.1±6.1 years old) were treated with PolyScope holmium laser lithotripsy for renal calculi at Xin Hua Hospital (Shanghai, China). The mean stone digitized surface area was 154.2±57.7 mm2 (range, 55.8–478.3 mm2). A thorough medical history investigation, and laboratory and radiological examination were followed by proper preoperative management. The PolyScope was then passed into the renal cavities following the position of the ureteral access sheath, with laser energy maintained at 1.0–2.0 J, frequency 10–15 Hz. The demographical and operative information of senile patients were compared with that of the 332 non-senile patients operated at the same period time. The average operative time was 54.6±13.2 min (range, 37–124 min). No major complications, including ureteral perforation or sepsis were encountered. The single session stone-free rate (SFR) was 81.5% and the overall SFR was 89.2%, similar to that of the non-senile group. PolyScope combined with holmium laser lithotripter is safe and effective in managing renal calculi in senile patients compared with non-senile patients, with considerately high SFRs and low complication rates.

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Comparison of safety and outcomes of shock wave lithotripsy between elderly and non-elderly patients

Cited by 8 publications

References 16 publications

Clinical results of shock wave lithotripsy treatment in elderly patients with kidney stones: Results of 1433 patients

Clinical results of shock wave lithotripsy treatment in elderly patients with kidney stones: Results of 1433 patients

Surgical management of urolithiasis in octogenarians

Flexible ureteroscopic holmium laser lithotripsy with PolyScope for senile patients with renal calculi

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