Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety
Kylie Yen-Yi Lim1, Amos Nepacina Liew1, Zihui Ling2
1Department of Urology, Monash Health, Melbourne, VIC 3168, Australia.
Journal of Clinical Medicine
|July 29, 2023
Summary
Modified supine percutaneous nephrolithotomy (PCNL) is safe for elderly patients (≥70 years). This technique offers benefits like reduced patient handling and good stone clearance rates, crucial for older individuals.
Area of Science:
- Urology
- Geriatric Surgery
Background:
- The aging population necessitates evaluation of surgical techniques for age-related conditions.
- Modified supine percutaneous nephrolithotomy (PCNL) is gaining traction, but safety data in elderly patients are limited.
Purpose of the Study:
- To assess the safety and efficacy of modified supine PCNL in patients aged 70 years and older.
- To evaluate outcomes including complications, stone clearance, and length of stay in this demographic.
Main Methods:
- Prospective evaluation of 69 modified supine PCNL procedures in 67 patients (mean age 76.5 years) over 10 years.
- Data collected included operative time, complications (Clavien-Dindo classification), stone burden, stone clearance, and hospital stay.
Main Results:
- Complete stone clearance was achieved in 66.7% of patients.
- Complications occurred in 17.4% of patients, with most being low-grade (Clavien-Dindo II or less).
- Median operative time was 95 minutes; 29% underwent combined procedures.
Conclusions:
- Modified supine PCNL is a safe and effective procedure for elderly patients.
- Advantages include reduced patient handling and effective stone removal, important for older patients with limited tolerance.
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