Yaşlı Hastalarda Perkütan Nefrolitotomi Komplikasyonu Öngörücü Faktörleri

Yıl 2025, Cilt: 17 Sayı: 1, 24 - 35, 31.01.2025

Taha Çetin , Derşan Onur

Öz

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.

Anahtar Kelimeler

Yaşlı, perkütan nefrolitotomi, komplikasyon, nomogram, öngörücü

Predictive Factors for Percutaneous Nephrolithotomy Complications in Elderly Patients

Öz

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.

Anahtar Kelimeler

Elderly, percutaneous nephrolithotomy, complication, nomogram, prediction

Etik Beyan

Sağlık Bilimleri Üniversitesi İzmir Tepecik Eğitim ve Araştırma Hastanesi Etik Kurulu'ndan 15.03.2022 tarihli (2022/03-05). Protokol no ile onay alınmıştır (2022/03-05).

Kaynakça

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