Percutaneous nephrolithotomy in octogenarians and beyond: How old is too old?

doi:10.1016/j.ajur.2015.08.005

Asian Journal of Urology, 2015, 2 (4): 208-213 doi: 10.1016/j.ajur.2015.08.005

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Percutaneous nephrolithotomy in octogenarians and beyond: How old is too old?

Bradley Morganstern, Riccardo Galli, Piruz Motamedinia, David Leavitt, Mohamed Keheila, Eric Ghiraldi, David Hoenig, Arthur Smith, Zeph Okeke

The Smith Institute for Urology, NorthShore-Long Island Jewish Health System, New Hyde Park, NY, USA

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Abstract Objective: To specifically report perioperative characteristics and outcomes in patients 80 years and older undergoing percutaneous nephrolithotomy (PCNL). PCNL has been established as feasible in the elderly; however, to our knowledge no one has specifically reported feasibility in patients 80 years and older. Methods: We retrospectively reviewed perioperative data of octogenarians who underwent PCNL at a high stone volume single institution, and matched them to patients <65 years of age by stone burden and sex. Patient demographics, perioperative outcomes and postoperative complications were compared. Results: Thirty-three octogenarians (mean age 83.6 years) with 36 renal units were matched to 67 controls (mean age 48.6 years) with 72 renal units. Octogenarians had a higher mean American Society of Anesthesiologists (ASA) score, more comorbidities, and worse renal function. There were no differences in operative characteristics, length of hospital stay or stone free rates. Of the patients with preoperative urinary decompression (ureteral stent or nephrostomy tube) prior to PCNL, the elderly were more likely to have a history of urosepsis. Octogenarians did not experience more minor Clavien (I-II) or major Clavien (IIIa-IVb) complications. Conclusion: Octogenarians who undergo PCNL were more likely to have cardiovascular comorbidities and a prior history of sepsis. Despite these risk factors, in appropriately selected patients PCNL can be safely and successfully performed in octogenarians without increased perioperative complications relative to a younger cohort.

Key words： Percutaneous nephrolithotomy Elderly Percutaneous stone extraction complications Clavien Octogenarians Percutaneous stone extraction

Received: 24 April 2015 Published: 29 October 2015

Corresponding Authors: Bradley Morganstern E-mail: bam040880@yahoo.com

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	Bradley Morganstern
	Riccardo Galli
	Piruz Motamedinia
	David Leavitt
	Mohamed Keheila
	Eric Ghiraldi
	David Hoenig
	Arthur Smith
	Zeph Okeke

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Cite this article:

Bradley Morganstern,Riccardo Galli,Piruz Motamedinia, et al. Percutaneous nephrolithotomy in octogenarians and beyond: How old is too old?[J]. Asian Journal of Urology, 2015, 2(4): 208-213.

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http://www.ajurology.com/EN/10.1016/j.ajur.2015.08.005 OR http://www.ajurology.com/EN/Y2015/V2/I4/208

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