Materials and Methods
This study is a retrospective analysis of patients over 65 years of age
who undergoing PCNL or RIRS for kidney stones at the Ministry of Health
University Izmir Bozyaka Training and Research Hospital between April
2011 and January 2020. The data were driven from the electronic medical
records of all the patients consecutively. Patients who had history of
neuromuscular disease, congenital renal anomalies, coagulopathy, morbid
obesity, skeletal deformity, solitary kidney and <65 years of
age were excluded from the study. A total of 161 patients, were divided
into two groups according to surgical technique; PCNL Group n = 89, and
RIRS Group n=72. Comparisons were made among patient demographics, and
perioperative and postoperative outcomes.
The following data were recorded by the two surgeons (SY and MS)
immediately postoperatively: patient demographics (age, gender, body
mass index, operation side, location of the stones, stone burden,
Metabolic Syndrome: there were at least two illnesses (diabetes
mellitus, hypertension, hyperlipidemia and obesity) and preoperative
data (table-1). Perioperative data included surgery time, fluoroscopy
time, length of stay, Change in Hgb and Change in creatinine (table-2).
Postoperative complications were noted according to the Clavien scoring
system (table-3).10 Complications according to Clavien
scoring system were divided two groups; Minor complications = Clavien
grades I-II, and Major complications = Clavien grades III-IV-V. Charlson
comorbidity index was measured for all patients. Correlation analysis
was used for intraoperative and postoperative results with CCI
(table-4). Complications rates were compared between RIRS and PCNL
according to the CCI (table-5)
Sterile urine culture was detected in all patients before operation.
Ceftriaxone was given as prophylaxis before the operation and continued
until the nephrostomy tube was removed. No Nephrotoxic drugs were used
before, during, or after the operation for any patient.
Stone burden was calculated with square millimeters in all patients :
length x width x π x 0.25, where π is a mathematical constante qualto
3.14.11 In multiple intrarenal stones, stone burden
was calculated one by one and then all of them were collected.
The estimated GFR was calculated using the Cockcroft–Gaultformula
(CrCl = ([140-age] × weight in kg) / (serum creatinine × 72) x 0,85
(if female).12 All PCNL and RIRS interventions were
performed by two surgeons (SY and MS).