TY  - JOUR
T1  - Yaşlı Hastalarda Perkütan Nefrolitotomi Komplikasyonu Öngörücü Faktörleri
TT  - Predictive Factors for Percutaneous Nephrolithotomy Complications in Elderly Patients
AU  - Çetin, Taha
AU  - Onur, Derşan
PY  - 2025
DA  - January
Y2  - 2025
DO  - 10.54233/endourolbull-1589609
JF  - Endoüroloji Bülteni
JO  - Endourol Bull
PB  - Endourology Association
WT  - DergiPark
SN  - 2148-0532
SP  - 24
EP  - 35
VL  - 17
IS  - 1
LA  - tr
AB  - Amaç: Böbrek taşı nedeniyle perkütan nefrolitotomi yapılan 65 yaş üstündeki hastalarda komplikasyonu ve rezidü taşı öngören faktörleri araştırmak.Gereç ve Yöntemler: Kliniğimizde 11/2008 ile 08/2018 tarihleri arasında böbrek taşı nedeniyle perkütan nefrolitotomi (PNL) yapılan 1114 hastanın verileri retrospektif olarak tarandı. 65 yaş üstündeki 122 hastanın preoperatif tomografileri ve taş skorlama sistemlerinin değerlendirdiği çeşitli parametreler ile postoperatif komplikasyon ve taşsızlık durumları karşılaştırıldı. Bulgular: Cinsiyet, VKİ ve taş yoğunluğu her iki grupta istatistiksel olarak farklı değildi. Ancak rezidü taşı olan grupta böbrek anomalisi, GUY’s skoru, CROES skoru, Staghorn taş varlığı, kan transfüzyon oranı, komplikasyon oranı ve skopi süresi anlamlı olarak daha yüksek saptandı. Postoperatif taşsızlık oranı ile skorlama sistemleri GUY’S ve CROES arasında istatistiksel olarak anlamlı derecede ilişki saptanırken komplikasyon oranı değerlendirildiğinde sadece ağırlık ve skopi süreleri faktörlerinin istatistiksel olarak anlamlı ilişki saptandı.Sonuç: Perkütan nefrolitotomi yaşlı hastalarda da güvenle uygulanabilir. Ancak daha genç popülasyona göre komplikasyon oranlarının daha yüksek olması preoperatif değerlendirmede ve ameliyat sürecinde unutulmaması gereken önemli bir noktadır.
KW  - Yaşlı
KW  - perkütan nefrolitotomi
KW  - komplikasyon
KW  - nomogram
KW  - öngörücü
N2  - Objective: To investigate the factors predicting complications and residual calculi (efficacy of stone nomograms) in patients over 65 years of age undergoing percutaneous nephrolithotomy for renal calculi.Material and Methods: Data of 1114 patients who underwent percutaneous nephrolithotomy (PNL) for kidney stones between 11/2008 and 08/2018 in our clinic were retrospectively reviewed. In 122 patients over 65 years of age, preoperative CT scans and various parameters evaluated by scoring systems and postoperative stone-free status were compared. Patients were divided into groups according to stone-free and complication status, and intragroup evaluation was performed for both conditions.Results: Gender, BMI and stone density were not statistically different in the groups with and without residual stones. However, renal anomaly, GUY's score, CROES score, presence of Staghorn stone, blood transfusion rate, complication rate, and scopy time were significantly higher in the group with residual stone. There was a statistically significant correlation between postoperative stone-free rate with height and CROES, whereas only weight and scopy time were statistically significantly correlated with complication rate. Conclusion: Percutaneous nephrolithotomy can be safely performed in elderly patients. However, the higher complication rates compared to the younger population is an important point that should be kept in mind during preoperative evaluation and operation.
CR  - Lim KYY, Liew AN, Ling Z, Ranasinghe W, McCahy P. Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety. JCM. 2023;12(14):4807. https://doi.org/10.3390/jcm12144807
CR  - Türk C, Petřík A, Sarica K, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. European Urology. 2016;69(3):475-482. https://doi.org/10.1016/j.eururo.2015.07.041
CR  - Alkiş O, Kartal İ, Aras B, Sevi̇M M, Sönmez OY. Evaluation of Safety and Factors Affecting Complications of Percutaneous Nephrolithotomy in Elderly. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2021;54(2):307-312. https://doi.org/10.20492/aeahtd.931349
CR  - Johnston AW, Jiang R, Alkazemi MH, et al. Nationwide Readmission Rates Following Percutaneous Nephrolithotomy: Does Age Matter? Journal of Endourology. 2019;33(9):704-711. https://doi.org/10.1089/end.2019.0239
CR  - Abedali ZA, Large T, Heiman JM, et al. Percutaneous Nephrolithotomy in the 80 Years of Age and Older Population. Urology. 2019;134:62-65. https://doi.org/10.1016/j.urology.2019.08.044
CR  - Unsal A, Resorlu B, Atmaca AF, et al. Prediction of Morbidity and Mortality After Percutaneous Nephrolithotomy By Using the Charlson Comorbidity Index. Urology. 2012;79(1):55-60. https://doi.org/10.1016/j.urology.2011.06.038
CR  - Ali MW, Azmi YA, Tarmono, Soebadi DM. Percutaneous Nephrolithotomy (PCNL) in Older and Younger Patients at a Tertiary Hospital in Surabaya, Indonesia. FMI. 2023;59(1):26-31. https://doi.org/10.20473/fmi.v59i1.40968
CR  - Falahatkar S, Esmaeili S, Javid MR, Aali S, Eslami-Kenarsari H. Outcomes of Complete Supine Percutaneous Nephrolithotomy: Comparison of Elderly and Young Patients. Urological Science. 2023;34(4):194-198. https://doi.org/10.4103/UROS.UROS_23_23
CR  - Haberal HB, Gudeloglu A, Deger M, et al. Percutaneous Nephrolithotomy in Young-Old, Old-Old, and Oldest-Old Patients: A Multicenter Study. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2021;31(7):796-802. https://doi.org/10.1089/lap.2020.0537
CR  - Şahin A, Atsü N, Erdem E, et al. Percutaneous Nephrolithotomy in Patients Aged 60 Years or Older. Journal of Endourology. 2001;15(5):489-491. https://doi.org/10.1089/089277901750299276
CR  - Haider R, Regnier P, Roustan FR, et al. Néphrolithotomie percutanée des calculs rénaux des personnes âgées : méta-analyse des résultats et complications. Progrès en Urologie. 2017;27(2):58-67. https://doi.org/10.1016/j.purol.2016.12.008
CR  - Okeke Z, Smith AD, Labate G, et al. Prospective Comparison of Outcomes of Percutaneous Nephrolithotomy in Elderly Patients Versus Younger Patients. Journal of Endourology. 2012;26(8):996-1001. https://doi.org/10.1089/end.2012.0046
CR  - Tseng JS, Lin WR, Sun FJ, et al. Predicting Percutaneous Nephrolithotomy Outcomes and Complications in Elderly Patients Using Guy’s Scoring System and Charlson Comorbidity Index. International Journal of Gerontology. 2018;12(3):239-243. https://doi.org/10.1016/j.ijge.2018.05.001
CR  - Akman T, Binbay M, Ugurlu M, et al. Outcomes of Retrograde Intrarenal Surgery Compared with Percutaneous Nephrolithotomy in Elderly Patients with Moderate-Size Kidney Stones: A Matched-Pair Analysis. Journal of Endourology. 2012;26(6):625-629. https://doi.org/10.1089/end.2011.0526
CR  - Liu J, Gu J, Xu W, et al. Efficacy and safety of percutaneous nephrolithotripsy in elderly patients: a retrospective study. BMC Surg. 2022;22(1):392. https://doi.org/10.1186/s12893-022-01830-6
CR  - Polat S, Yarimoglu S, Ömer K, et al. Comparison of Guy’s, S.T.O.N.E. and CROES Scoring Systems for Predicting Percutaneous Nephrolithotomy Outcomes in Eldery Patients. J Coll Physicians Surg Pak. 2021;31(03):307-313. https://doi.org/10.29271/jcpsp.2021.03.307
CR  - Mandal S, Goel A, Kathpalia R, et al. Prospective evaluation of complications using the modified Clavien grading system, and of success rates of percutaneous nephrolithotomy using Guy’s Stone Score: A single-center experience. Indian Journal of Urology. 2012;28(4):392-398. https://doi.org/10.4103/0970-1591.105749
CR  - Vicentini FC, Marchini GS, Mazzucchi E, Claro JFA, Srougi M. Utility of the Guy’s Stone Score Based on Computed Tomographic Scan Findings for Predicting Percutaneous Nephrolithotomy Outcomes. Urology. 2014;83(6):1248-1253. https://doi.org/10.1016/j.urology.2013.12.041
CR  - Choi SW, Bae WJ, Ha US, et al. Prognostic Impact of Stone-Scoring Systems After Percutaneous Nephrolithotomy for Staghorn Calculi: A Single Center’s Experience Over 10 Years. Journal of Endourology. 2016;30(9):975-981. https://doi.org/10.1089/end.2016.0188
CR  - Kumar S, Sreenivas J, Karthikeyan VS, Mallya A, Keshavamurthy R. Evaluation of CROES Nephrolithometry Nomogram as a Preoperative Predictive System for Percutaneous Nephrolithotomy Outcomes. Journal of Endourology. 2016;30(10):1079-1083. https://doi.org/10.1089/end.2016.0340
CR  - Labadie K, Okhunov Z, Akhavein A, et al. Evaluation and Comparison of Urolithiasis Scoring Systems Used in Percutaneous Kidney Stone Surgery. Journal of Urology. 2015;193(1):154-159. https://doi.org/10.1016/j.juro.2014.07.104
CR  - Noureldin YA, Elkoushy MA, Andonian S. Which is better? Guy’s versus S.T.O.N.E. nephrolithometry scoring systems in predicting stone-free status post-percutaneous nephrolithotomy. World J Urol. 2015;33(11):1821-1825. https://doi.org/10.1007/s00345-015-1508-5
CR  - Nakamon T, Kitirattrakarn P, Lojanapiwat B. Outcomes of percutaneous nephrolithotomy: Comparison of elderly and younger patients. Int braz j urol. 2013;39(5):692-701. https://doi.org/10.1590/S1677-5538.IBJU.2013.05.12
CR  - Al Adl AM, Mohey A, Abdel Aal A, Abu-Elnasr HAF, El Karamany T, Noureldin YA. Percutaneous Nephrolithotomy Outcomes Based on S.T.O.N.E., GUY, CROES, and S-ReSC Scoring Systems: The First Prospective Study. Journal of Endourology. 2020;34(12):1223-1228. https://doi.org/10.1089/end.2019.0856
CR  - Tailly TO, Okhunov Z, Nadeau BR, et al. Multicenter External Validation and Comparison of Stone Scoring Systems in Predicting Outcomes After Percutaneous Nephrolithotomy. Journal of Endourology. 2016;30(5):594-601. https://doi.org/10.1089/end.2015.0700
CR  - Iqbal N, Iqbal S, Hasan A, et al. Outcomes Of Percutaneous Nephrolithotomy In Elder Age Patients-Single Center Experience. J Ayub Med Coll Abbottabad. 2021;33(2):217-221. PMID: 34137532
UR  - https://doi.org/10.54233/endourolbull-1589609
L1  - https://dergipark.org.tr/en/download/article-file/4386022
ER  -