Published in:
01-12-2020 | Urology - Original Paper
Safety and efficacy of retrograde intrarenal surgery in geriatric patients by age groups
Published in: International Urology and Nephrology | Issue 12/2020
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Purpose
To evaluate the effects of aging on the success rate of retrograde intrarenal surgery (RIRS) and the development of medical and surgical complications by dividing geriatric patients into subgroups based on their chronological age.
Method
Data of the patients who underwent RIRS due to kidney stones at our clinic between June 2014 and January 2020 were retrospectively reviewed. Patients were divided into three groups based on age: 65–74 years (Group 1), 75–84 years (Group 2), and ≥ 85 years (Group 3). The comorbid diseases of patients were evaluated using the Charlson Comorbidity Index (CCI), total Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score, and CIRS severity index (CIRS-G SI). RIRS success rates and complications were evaluated based on age groups.
Results
A total of 336 patients were included in the study. The mean age of the patients was 72.7 ± 6.59 years. Stone-free rate was 81.5% in patients aged > 65 years and did not change with age. The modified Clavien–Dindo grade I/II complication rates for surgical complications were similar in all three groups (p = 0.818). In the evaluation of ROC analysis for medical complications, it was observed that the cut-off values were 76.5 years, CIRS-G score of 4.5, CCI score of 2.5, and CIRS-SI score of 1.18 (p < 0.001).
Conclusion
RIRS is an effective and safe treatment option for kidney and proximal ureteral stones in geriatric patients. Although there is an increase in medical complications post-RIRS with aging, surgical complications and stone-free rates remain unchanged.