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J Coll Physicians Surg Pak · Jun 2021
Safety and Efficacy of Flexible Ureterorenoscopy Surgery in Different Age Groups.
- Omer Koras, Ibrahim Halil Bozkurt, Ahmet Nihat Karakoyunlu, Salih Polat, Serkan Yarimoglu, and Tansu Degirmenci.
- Department of Urology, Faculty of Medicine, Mustafa Kemal University, Antakya/Hatay, Turkey.
- J Coll Physicians Surg Pak. 2021 Jun 1; 31 (6): 679685679-685.
ObjectiveTo comparatively investigate the efficacy, safety and complications of flexible ureterorenoscopy (f-URS) in the treatment of patients of different age groups (<60, 60-74 and ≥75 years) with proximal ureteral and kidney stones.Study DesignDescriptive study.Place And Duration Of StudyDepartment of Urology, HSU Izmir Bozyaka Training and Research Hospital, HSU Ankara Diskapi Training, Research Hospital, and Mustafa Kemal University Faculty of Medicine, between March 2014 and June 2020.MethodologyNine hundred and fifty-six patients, who underwent f-URS due to proximal ureteral and kidney stones, were divided into three age groups as <60 years (Group 1), 60-74 years (Group 2) and ≥75 year (Group 3). The patients' American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), anticoagulant use, stone-free rates and surgical and medical complication rates were examined for each group.ResultsThere were 688 patients in Group 1, 230 in Group 2, and 38 in Group 3. A significant difference was observed between the age groups in terms of CCI and anticoagulant use (p<0.001 for both). The highest rate of medical complications was observed in Group 3 at 42.1%, followed by Group 2 at 17.8%, while the lowest rate was observed in Group 1 at 2.3% (p<0.001). As a result of the multivariate analysis, receiving anticoagulant treatment (p=0.002) and having a high CCI (p=0.005) were independent predictors of medical complication development.ConclusionIt was clearly demonstrated that f-URS could be used as a safe and effective alternative for the treatment of moderate-size kidney stones in all age groups. Key Words: Elderly, Geriatric patients, RIRS, Holmium laser lithotripsy, Urolithiasis, Safety, Efficacy.
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