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Effect of Age on Percutaneous Nephrolithotomy for Staghorn Renal Stones
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  • Murat Sahan,
  • Serkan Yarımoğlu,
  • Metin Savun,
  • Onur Erdemoglu,
  • Tansu Degirmenci
Murat Sahan
Izmir Bozyaka Training and Research Hospital

Corresponding Author:[email protected]

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Serkan Yarımoğlu
Izmir Bozyaka Training and Research Hospital
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Metin Savun
Siverek State Hospital
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Onur Erdemoglu
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Tansu Degirmenci
University of Health Sciences Izmir Bozyaka Education and Research Hospital
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Objective: To evaluate the effect of age on the success and complications of percutaneous nephrolithotomy(PCNL) in staghorn renal stones. Material and Methods: The files of 182 patients who underwent single-access PCNL for staghorn renal stones between 2012 and 2017 were retrospectively analyzed.The patients were divided into two groups according to their age: those aged <65 years were defined as Group-1 and those aged ≥65 years as Group-2.The demographic characteristics and perioperative and postoperative results of the patients were compared between the two groups.Postoperative detection of stones>4 mm was defined as residual stones.Complications were classified according to the Clavien scoring system. Results: Of the patients with staghorn renal stones,139 were in Group-1 and 43 were in Group-2. The mean age of the patients was 43.9±10.6 years for Group-1 and 67.8±2.1 years for Group-2(p=0.001).The mean stone size in Group-1 and Group-2 was 899±292 and 1,008±208 mm2, respectively(p=0.736). When we evaluated the postoperative results, we observed that the amount of hemoglobin drop was statistically significantly higher in Group-1(p=0.001). However, the need for blood transfusion was higher in Group-2 than in Group-1(18.6% and 7.2%, respectively). The stone-free rate was 54.7% in Group-1 and 67.4% in Group-2(p=0.139). According to the evaluation of the overall complication rates,34.5% of the patients in Group-1 and 46.5% of those in Group-2 developed complications(p=0.206). When we examined the subgroups of complications according to the Clavien scoring system, the rate of minor complications was found to be 22.3% in Group-1 and 41.9% in Group-2,and the difference was statistically significant(p=0.012). The major complication rates were determined as 4.7% and 12.2% for Group-1 and Group-2,respectively(p=0.155). The number of patients with Clavien grade-2 complications was statistically higher in the elderly patient group(p=0.019). Conclusion: PCNL can be used as an effective and safe treatment method in the treatment of complex stones in elderly patients