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Tubeless versus standard PCNL in geriatric population
1Department of Urology, School of Medicine, Sifa University, Izmir, Turquía.
Actas Urologicas Espanolas
|May 5, 2015
Summary
Tubeless percutaneous nephrolithotomy (PCNL) is safe and effective for geriatric patients with large kidney stones. This approach offers shorter hospital stays and reduced analgesic needs compared to standard PCNL.
Area of Science:
- Urology
- Nephrology
- Geriatric Medicine
Background:
- Percutaneous nephrolithotomy (PCNL) is a primary treatment for large renal calculi.
- Traditionally, PCNL involves a nephrostomy tube, but advancements allow for tubeless procedures.
- The geriatric population presents unique considerations for surgical interventions.
Purpose of the Study:
- To evaluate the safety and efficacy of tubeless PCNL in patients aged 65 and older.
- To compare tubeless PCNL with standard PCNL in the geriatric population.
Main Methods:
- A retrospective comparison of 52 patients (≥65 years) with renal calculi >2cm undergoing PCNL.
- 25 patients underwent tubeless PCNL, and 27 underwent standard PCNL.
- Comparison parameters included stone burden, analgesic use, hospitalization length, and success rates.
Main Results:
- Both tubeless and standard PCNL demonstrated high success rates (96.0% and 96.3%).
- Tubeless PCNL showed significantly lower stone burden, shorter operation duration, and reduced narcotic analgesic use.
- Hospital stay was significantly shorter in the tubeless PCNL group (1.7 days vs. 2.6 days).
Conclusions:
- Tubeless PCNL is a safe and effective alternative to standard PCNL in geriatric patients.
- The tubeless approach offers benefits including reduced hospitalization and analgesic requirements.
- Earlier mobilization is also an advantage of tubeless PCNL in the elderly.
