Safety and Efficacy of RIRS in Geriatric Patients: A Comparative Evaluation on an Age Based Manner
Vol. 17 No. 2 (2020),
16 March 2020
AbstractPurpose: In this retrospective study, we aimed to comparatively evaluate the efficacy and safety of RIRS procedure on an age-based manner in patients younger and above 65 years.
Materials and Methods: A total of 165 patients undergoing RIRS procedure for renal stones were divided into two groups on an age-based manner namely; Group 1 (n=122) patients aging < 65 years and Group 2 (n=43) patients aging above 65 years. Demographic and clinical data regarding the stone free rates, complication rates and need for secondary procedures were retrospectively evaluated.
Results: Of all the patients undergoing RIRS for kidney stones, 122 were below the age of 65 (73.9%) and 43 were above the age of 65 (26.1%). Mean age value for the patients aging more than 65 years was 74.16 ± 5.03 years and in addition to higher percentage of comorbidities, serum creatinine levels as well as ASA scores were also higher in this group when compared with younger counterparts. Although there was no statistically significant difference with respect to the operative duration, stone-free rates (SFR) and hospitalization period between the two groups, both complication rates and the need for additional interventions were higher in the older patient group (p = 0.038; p = 0.032). All complications noted in the both groups were minor (Grade I) complications according to the Clavien classification system.
Conclusion: RIRS procedure can be applied as an effective and safe treatment alternative for the minimal invasive management of renal stones in relatively older patients (> 65 years) with similar hospitalization as well as stone free rates noted in the younger patients. No procedure related severe complication was noted in these cases.
How to Cite
Chatterji S, Byles J, Cutler D, et al. Health, functioning, and disability in older adults-present status and future implications. Lancet (London, England). 2015 Feb; 385(9967):563–75.
McCarthy JP, Skinner TAA, Norman RW. Urolithiasis in the elderly. Can J Urol [Internet]. 2011 Jun; 18(3):5717–20.
Hu H, Lu Y, He D, et al. Comparison of minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of intermediate proximal ureteral and renal stones in the elderly. Urolithiasis. 2016 Oct ; 44(5):427–34.
Tonner PH, Kampen J, Scholz J. Pathophysiological changes in the elderly. Best Pract Res Clin Anaesthesiol. 2003 Jun; 17(2):163–77.
Marchini GS, Mello MF, Levy R, et al. Contemporary Trends of Inpatient Surgical Management of Stone Disease: National Analysis in an Economic Growth Scenario. J Endourol. 2015 Aug; 29(8):956–62.
Rosette J, Assimos D, Desai M, et al. The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol. 2011 Jan; 25(1):11–7.
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. J Endourol. 2012 Jun; 26(6):625–9.
De S, Autorino R, Kim FJ, et al. Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis. Eur Urol. 2015 Jan; 67(1):125–37.
Türk C, Petřík A, Sarica K, et al. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016 Mar; 69(3):468–74.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug; 240(2):205–13.
Trinchieri A. Epidemiology of urolithiasis:an update. Clin Cases Miner Bone Metab. 2008 May;5(2):101- 6.
Knoll T, Schubert AB, Fahlenkamp D, et al. Urolithiasis Through the Ages: Data on More Than 200,000 Urinary Stone Analyses. J Urol. 2011 Apr;185(4):1304–11.
Giusti G, Proietti S, Cindolo L, et al. Is retrograde intrarenal surgery a viable treatment option for renal stones in patients with solitary kidney? World J Urol. 2015 Mar; 33(3):309–14.
Zheng C, Xiong B, Wang H, et al. Retrograde intrarenal surgery versus percutaneous nephrolithotomy for treatment of renal stones >2 cm: a meta-analysis. Urol Int. 2014;93(4):417–24.
Berardinelli F, De Francesco P, Marchioni M, et al. RIRS in the elderly: Is it feasible and safe? Int J Surg. 2017 Jun; 42:147–51.
Geraghty R, Abourmarzouk O, Rai B, et al. Evidence for Ureterorenoscopy and Laser Fragmentation (URSL) for Large Renal Stones in the Modern Era. Curr Urol Rep. 2015 Aug;16(8):54.
Skolarikos A, Gross AJ, Krebs A, et al. Outcomes of Flexible Ureterorenoscopy for Solitary Renal Stones in the CROES URS Global Study. J Urol. 2015 Jul; 194(1):137–43.
de la Rosette JJ, Opondo D, Daels FP, et al. Categorisation of Complications and Validation of the Clavien Score for Percutaneous Nephrolithotomy. Eur Urol. 2012 Aug; 62(2):246–55.
Karakoyunlu N, Goktug G, Şener NC, et al. A comparison of standard PCNL and staged retrograde FURS in pelvis stones over 2 cm in diameter: a prospective randomized study. Urolithiasis. 2015 Jun ; 43(3):283–7.
Kamphuis GM, Baard J, Westendarp M, et al. Lessons learned from the CROES percutaneous nephrolithotomy global study. World J Urol. 2015 Feb; 33(2):223–33.
de la Rosette JJ, Opondo D, Daels FP, et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012 Aug; 62(2):246–55.
Sahin A, Atsü N, Erdem E, et al. Percutaneous nephrolithotomy in patients aged 60 years or older. J Endourol. 2001 Jun; 15(5):489–91.
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