Austin Health

Title
RIRS in the elderly: Is it feasible and safe?
Publication Date
2017-06
Author(s)
Berardinelli, F
De Francesco, P
Marchioni, M
Cera, N
Proietti, S
Hennessey, Derek B
Dalpiaz, O
Cracco, C
Scoffone, C
Giusti, G
Cindolo, L
Schips, L
Subject
Age
Elderly patients
Flexible ureteroscopy
RIRS
Type of document
Journal Article
OrcId
0000-0002-7372-0100
DOI
10.1016/j.ijsu.2017.04.062
Abstract
The aim of this study was to compare the safety and efficacy of RIRS in men ≥65 years to those <65 years. Patients who underwent RIRS were prospectively collected from March 2013 to March 2014 in 5 European centers. Perioperative outcomes and complications in elderly men were compared with men <65 years. Univariable and multivariable analyses were performed for factors predicting overall complications. The groups were compared using Mann-Whitney U test. Categorical variables were compared using chi-squared test and the Yates correction or the Fisher's exact test. A total of 399 patients with renal stones were included, 308 (77.19%) were aged <65 years, 91 (22.8%) were aged ≥65 years. Elderly patients were more likely to have higher ASA scores (35.7% vs 92.3%; p < 001), Charlson Comorbidity Index (1.8 vs. 5.2, p < 0.001), hyperlipidemia (10.06% vs. 30.76%; p = 0,0005) and coronary heart disease (5.51% vs. 17.58; p = 0.005) compared to younger cohort. Perioperative outcomes (stone free rate, operative time and re-intervention rate) did not show differences between the two groups (p > 0.05). Surgical and medical complication rates were similar between the cohorts (14.28% vs 9.89%; p = 0.38). Multivariate analysis did not identify any predictive factors of complications among the two groups (p > 0.05). In this study, elderly RIRS patients had comparable short term efficacy and perioperative complications to younger patients, despite a higher prevalence of comorbidity. Age itself should not be considered as a risk factor for the development of complications in patients undergoing RIRS for renal stone.
Link
Citation
International journal of surgery (London, England) 2017; 42: 147-151
Jornal Title
International journal of surgery (London, England)

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