Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety
With increases in the aging population, conditions affecting older people and relevant surgical techniques are becoming more pertinent. Modified supine percutaneous nephrolithotomy (PCNL) is increasingly being adopted. There are limited data on the safety of this position in the elderly patient popu...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/14/4807 |
| _version_ | 1797588843579310080 |
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| author | Kylie Yen-Yi Lim Amos Nepacina Liew Zihui Ling Weranja Ranasinghe Philip McCahy |
| author_facet | Kylie Yen-Yi Lim Amos Nepacina Liew Zihui Ling Weranja Ranasinghe Philip McCahy |
| author_sort | Kylie Yen-Yi Lim |
| collection | DOAJ |
| description | With increases in the aging population, conditions affecting older people and relevant surgical techniques are becoming more pertinent. Modified supine percutaneous nephrolithotomy (PCNL) is increasingly being adopted. There are limited data on the safety of this position in the elderly patient population. We describe our experience of the modified supine position in patients aged 70 years and older. Between April 2011 and March 2021, patients aged 70 years and older undergoing a modified supine PCNL performed by a single surgeon were prospectively evaluated. Data including patient age, operative time, complications, stone clearance, and length of stay were collected and analysed. Sixty-nine procedures were performed on 67 patients with a mean age was 76.5 years. Median total operative time was 95 min with 20 (29%) patients having a combined procedure with ureterorenoscopy. Preoperative mean stone burden was 23.5 mm and complete stone clearance was achieved in 46 (66.7%) patients. Twelve (17.4%) patients had complications during their hospitalisation. Six were Clavien–Dindo class II or less and one Clavien–Dindo class V. The modified supine position for PCNL is safe in the elderly patient population and has advantages including reduced handling of patients and achieving adequate stone-free rates. These benefits are particularly important in the elderly population, which frequently has a reduced tolerance to adaptation. |
| first_indexed | 2024-03-11T00:57:53Z |
| format | Article |
| id | doaj.art-94fece9cec644307a9afd77f47ccf98f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T00:57:53Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-94fece9cec644307a9afd77f47ccf98f2023-11-18T19:54:15ZengMDPI AGJournal of Clinical Medicine2077-03832023-07-011214480710.3390/jcm12144807Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and SafetyKylie Yen-Yi Lim0Amos Nepacina Liew1Zihui Ling2Weranja Ranasinghe3Philip McCahy4Department of Urology, Monash Health, Melbourne, VIC 3168, AustraliaDepartment of Urology, Monash Health, Melbourne, VIC 3168, AustraliaSchool of Medicine, Monash University, Clayton, VIC 3800, AustraliaDepartment of Urology, Monash Health, Melbourne, VIC 3168, AustraliaDepartment of Urology, Monash Health, Melbourne, VIC 3168, AustraliaWith increases in the aging population, conditions affecting older people and relevant surgical techniques are becoming more pertinent. Modified supine percutaneous nephrolithotomy (PCNL) is increasingly being adopted. There are limited data on the safety of this position in the elderly patient population. We describe our experience of the modified supine position in patients aged 70 years and older. Between April 2011 and March 2021, patients aged 70 years and older undergoing a modified supine PCNL performed by a single surgeon were prospectively evaluated. Data including patient age, operative time, complications, stone clearance, and length of stay were collected and analysed. Sixty-nine procedures were performed on 67 patients with a mean age was 76.5 years. Median total operative time was 95 min with 20 (29%) patients having a combined procedure with ureterorenoscopy. Preoperative mean stone burden was 23.5 mm and complete stone clearance was achieved in 46 (66.7%) patients. Twelve (17.4%) patients had complications during their hospitalisation. Six were Clavien–Dindo class II or less and one Clavien–Dindo class V. The modified supine position for PCNL is safe in the elderly patient population and has advantages including reduced handling of patients and achieving adequate stone-free rates. These benefits are particularly important in the elderly population, which frequently has a reduced tolerance to adaptation.https://www.mdpi.com/2077-0383/12/14/4807elderly patientsmodified supinenephrolithiasispercutaneous nephrolithotomy |
| spellingShingle | Kylie Yen-Yi Lim Amos Nepacina Liew Zihui Ling Weranja Ranasinghe Philip McCahy Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety Journal of Clinical Medicine elderly patients modified supine nephrolithiasis percutaneous nephrolithotomy |
| title | Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety |
| title_full | Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety |
| title_fullStr | Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety |
| title_full_unstemmed | Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety |
| title_short | Modified Supine Percutaneous Nephrolithotomy in the Elderly: Outcomes and Safety |
| title_sort | modified supine percutaneous nephrolithotomy in the elderly outcomes and safety |
| topic | elderly patients modified supine nephrolithiasis percutaneous nephrolithotomy |
| url | https://www.mdpi.com/2077-0383/12/14/4807 |
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