Outcomes of Complete Supine Percutaneous Nephrolithotomy: Comparison of Elderly and Young Patients

Abstract

Abstract Purpose: Percutaneous nephrolithotomy (PCNL) in the elderly is challenging due to age-related decline in organ function and the general depletion of the physiological reserve. We aimed to compare the efficacy and safety of complete supine PCNL (csPCNL) between young and elderly patients with kidney stones. Materials and Methods: In this cross-sectional comparative study, a total of 656 patients aged 18–64 years (young group) and 83 patients aged ≥65 years (elderly group) who underwent csPCNL between April 2009 and September 2021 were studied. The two groups were compared in terms of clinical characteristics, stone-related parameters, perioperative parameters, and postoperative outcomes. Results: The mean age of elderly and young patients was 69.87 and 47.1 years, respectively. The female-to-male ratio was 1:1.21. The mean hemoglobin drop was significantly greater in the younger group (1.38 ± 1.08 vs. 1.01 ± 0.84 g/dL, P = 0.007). The stone-free rate was comparable in the two groups (96.8% vs. 91.5%), whereas hospitalization was significantly longer in the younger group (P = 0.014). There was no significant between-group difference regarding the postoperative complication rates (P = 0.36). On multivariate analysis, body mass index, stone burden, and presence of staghorn stone were identified as independent predictors of the success of the operation (P = 0.04, odds ratio [OR] = 1.091; P = 0.000, OR = 0.962; P = 0.045, OR = 0.404). None of these factors had an independent effect on the occurrence of postoperative complications (P > 0.05). Conclusion: CsPCNL in the elderly age group is an effective and safe procedure with high stone-free rates and similar complication rates compared to younger patients.