Tubeless Percutaneous Nephrolithotomy for Geriatric Patients

Abstract

Aim: To evaluate the safety of tubeless percutaneous nephrolithotomy (PCNL) in geriatric patients. Materials and Method: This is a retrospective review of 401 patients who received tubeless PCNL in a single institute. Among these, 50 were performed in patients aged older than 70 years (group 1), while 351 were performed in the remaining younger patients (group 2). Results: There was no significant difference in stone size between the 2 groups (3.6 ± 1.9 vs. 3.5 ± 2.0 cm). The average operative time was similar in both groups (92.8 ± 34.5 vs. 86.6 ± 32.0 min). The stone-free rate in groups 1 and 2 was 68.0% (34/50) and 83.8% (294/351), respectively, which was statistically significantly different. The average postoperative hospital stay was longer in group 1 (4.6 ± 3.4 days) than in group 2 (3.9 ± 2.5 days), but the difference was not statistically significant. There was no significant difference in postoperative urinary tract infection rate and blood transfusion rate in both groups (urinary tract infection: 18.0 vs. 8.8%; blood transfusion: 4 vs. 2.6%). Two patients in group 1 and 3 patients in group 2 experienced pulmonary complications. There was no other severe complication. Conclusion: Tubeless PCNL is a safe procedure for the treatment of geriatric patients with urolithiasis.

Comparison of outcomes of tubed versus tubeless percutaneous nephrolithotomy in children: A single center study

“…Tubeless PCNL has been a successful procedure even in advanced aged patients. [13,14] Shah et al [15] documented superiority of percutaneous nephrolithotomy in terms of patient's satisfaction. They reached a conclusion that PCNL was a safe technique even in solitary kidney, past history of any ipsilateral renal surgical procedure, elevated serum creatinine levels, with an advantage of bilateral simultaneous use of PCNL or contralateral endourological removal of stones.…”

Percutaneous nephrolithotomy for staghorn kidney stones in elderly patients

“…There are limited number of published studies concerning the management of urinary stones with PCNL in the elderly patient population [4][5][6][7][8][9]. Kandel advocated PCNL for the treatment of kidney stones larger than 2.5 cm in the elderly patients in 1990 [4].…”

Does Previous Open Nephrolithotomy Affect the Efficacy and Safety of Tubeless Percutaneous Nephrolithotomy?

“…We found that this technique is safe, economical and does not increase complications [3] . Tubeless PCNL was accepted in selected patients with lower analgesic requirement and shorter hospital stay [1][2][3][4][5] . The stenting techniques for tubeless PCNL with an externalized ureteral catheter and a double-J stent were compared.…”

“…Tubeless percutaneous nephrolithotomy (PCNL) is widely accepted for the treatment of renal and upper ureteral stones in selected cases [1][2][3][4][5] . This technique can decrease postoperative pain and hospital stay without increasing the rate of complications.…”