Geriatrik Hastalarda Perkütan Nefrolitotominin Güvenilirliğinin ve Komplikasyonları Etkileyen Faktörlerin Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı yaşlılarda perkutan nefrolitotominin (PNL) güvenliliğini ve etkinliğini araştırmaktır. Yöntem: Perkutan nefrolitotomi uygulanan 238 hastanın verileri geriye dönük olarak incelendi. Hastalar iki gruba ayrıldı (yaşlı:> 65, genç:<65 yaş). Demografik veriler, taş özellikleri, operasyon verileri ve komplikasyonlar gruplar arasında karşılaştırıldı. Bulgular: Çalışmaya 86 (% 36,1) yaşlı hasta dahil edildi. Demografik özellikler, başarı ve komplikasyon oranları açısından gruplar arasında anlamlı fark yoktu (p>0.05). Genelde taşsızlık oranı yaşlılarda % 86,0, genç hastalarda %86,8 idi (p>0.05). Çok değişkenli analizde; taş boyutu (p=0,032, OR=0,202 ve %95 CI=0.047-0.873) ve taş sayısı (p=0,002, OR=0,067 ve CI=0,012-0,377) yaşlı hastalarda komplikasyonlarla ilişkili bulundu. Sonuç: Perkutan nefrolitotomi yaşlı hastalarda güvenle ve yüksek başarı ile uygulanabilir. Taş sayısı ve yükü fazla olan geriatrik hastalarda PNL için komplikasyon riskinin arttığı unutulmamalıdır.

Anahtar Kelimeler

• Nefrolitotomi
• Perkütan
• Yaşlı
• Güvenlik

Evaluation of Safety and Factors Affecting Complications of Percutaneous Nephrolithotomy in Elderly

Öz

Purpose: This study aims to investigate the safety and efficacy of percutaneous nephrolithotomy (PNL) in the elderly. Methods: The data of 238 patients who underwent PNL were retrospectively analyzed. The patients were divided into two groups (elderly: >65). Demographic data, stone characteristics, operation data, and complications were compared between the elderly and younger patients. Results: Eighty-six (36.1%) elderly patients were included in the study. There was no significant difference between the groups in terms of demographic characteristics, success, and complication rates (p>0.05). The overall stone-free rate was 86.0% in the elderly and 86.8% in young patients (p>0.05). In multivariable analysis; stone size (p=0.032, OR=0.202 and %95 CI=0.047-0.873) and number of stones (p=0.002, OR=0.067 and CI=0.012-0.377) were found to be associated with complications in elderly. Conclusion: Percutaneous Nephrolithotomy can be performed safely with high success in elderly patients. It should be kept in mind that the risk of complications for PNL is increased in geriatric patients with a high number of stones and burden.

Anahtar Kelimeler

• Nephrolithotomy
• Percutaneous
• Elderly
• Safety

Kaynakça

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