Outcomes of retrograde intrarenal surgery compared to percutaneous nephrolithotomy in elderly patients with moderate-size kidney stones: A matched-pair analysis - Abstract

Objectives: The aim of our study was to evaluate the outcomes of retrograde intrarenal surgery (RIRS) in elderly patients with stones of moderate size.

Materials and Methods: Between September 2008 and June 2011, a total of 28 patients over 65 years of age with single renal stones that measured 1.5-3 cm were managed with RIRS. The outcomes of these patients were compared to the patients who underwent percutaneous nephrolithotomy (PCNL) using matched-pair analysis (1:1 scenario). The matching parameters were the size and location of the stone as well as age, gender, body mass index, degree of hydronephrosis, presence of previous SWL and open surgery. SPSS version 16 was used for statistical analysis.

Results: Stone-free rates after a single procedure were achieved in 82.1% of patients for the RIRS and 92.8% of patients for the PCNL group. The second flexible ureterorenoscopy procedure was performed for 5 patients in the RIRS group. Finally, stone-free rates during the third month of the follow-up period were 92.8% in the RIRS group and 96.4% in the PCNL group. The mean operative time per patient was 64.5±20.9 minutes in the RIRS group after total of 33 procedures, while it was 40.7±10.7 minutes in the PCNL groups (p< 0.0001). The overall complication rates for the RIRS and PCNL groups were 7.1% and 10.7%, respectively. Blood transfusions were required in 2 patients in the PCNL group. Hospitalization time was significantly shorter in the RIRS group (26.5±10.6 hrs for per patient vs. 60.0±28.8 hrs; p< 0.0001). In both groups, stones were most frequently composed of calcium oxalate (68.4% in the RIRS group and 77.7% in the PCNL group).

Conclusion: RIRS has a low complication rate and represents a safe and effective treatment alternative in selected geriatric patients with kidney stones of moderate size.

Written by:
Akman T, Binbay M, Ugurlu M, Kaba M, Akcay M, Yazici O, Ozgor F, Muslumanoglu AY.   Are you the author?
Haseki Teaching and Research Hospital, Department of Urology, Haseki Egitim ve Arastirma Hastanesi, Uroloji Klinigi, Istanbul, Turkey, 34390.

Reference: J Endourol. 2011 Dec 6. Epub ahead of print.
doi: 10.1089/end.2011.0526

PubMed Abstract
PMID: 22141372

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