Introduction: The geriatric stone population is not merely an extension of younger stone forming patients presenting at an older age but rather they commonly experience the first symptomatic stone episode de-novo later in life. This study aims to assess the preoperative parameters, Intraoperative parameters and postoperative complications of PCNL in Elderly patients above 60 years.
Materials and Methods: Observational study in 100 patients above the age of 60 years with large renal and upper ureteric calculus subjected to PCNL between october 2018 to october 2020 in a teritiary care center were evaluated and included based on the criteria as per study.
Results: In our study, the mean age among the group of patients who underwent study was 66 years with male predominance of 62%.Obstructive calculi with or without infection in 13% of patients.3 patients underwent preoperative decompression. The major concern in elderly were the comorbidities with 60% T2DM,44% SHTN,8%CAD and 1% CKD. Mean stone size was 21.12± 12.2mm.Mean operative time was 91minutes.Single tract used in almost 96% cases.2% had gross hematuria.12% had postoperative blood transfusion.4% had post operative fever treated with antibiotics and 1% had Urosepsis.PCN site urine leak in 1% of patients treated conservatively. Initial stone free rate was around 92%.Mean hospital stay was 2.47 days.
Conclusion: In elderly patients, prevalence of renal stone disease is found to be higher in males and patients most commonly present with flank pain, followed by fever. The presence of renal stones with obstruction and/or associated infection causes deranged renal parameters which may require preoperative diversion in the form of either PCN insertion or DJ stenting, which helps in mitigating this problem. Age related co morbidities or age itself should not be considered as discouraging factor while selecting PCNL as treatment modality in elderly patients with renal stone disease.
Impact Factor
2022: 6.012
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