Introduction & Objectives: As life expectancy increases, the number of elderly patients requiring surgical treatment for nephrolithiasis continues to rise. Although percutaneous nephrolithotomy (PCNL) remains the reference treatment for large and complex renal stones, concerns persist regarding its safety in older and potentially frailer individuals. We evaluated the impact of advanced age on perioperative outcomes following PCNL, comparing patients aged \u226575 years with a younger cohort.
\nMaterials & Methods: A retrospective analysis was conducted on 559 consecutive patients who underwent PCNL at a tertiary referral academic centre between January 2016 and July 2025. Demographic, clinical, stone-related and perioperative variables were collected. Comorbidity burden was assessed using the Charlson Comorbidity Index (CCI). Stone-free status (SFS) was defined as the absence of residual fragments on computed tomography performed three months after surgery. Postoperative complications were classified according to the modified Clavien\u2013Dindo system. Logistic regression models were used to identify predictors of postoperative complications.
\nResults: Among 559 patients, 63 (11.3%) were aged \u226575 years. Elderly patients showed a significantly higher comorbidity burden, higher baseline serum creatinine levels and lower preoperative haemoglobin values than younger individuals (all p\u22640.01). Stone burden and operative characteristics were comparable between groups. Stone-free rates did not differ according to age, while length of hospital stay was longer among geriatric patients. Postoperative complications occurred in 18.7% of patients aged \u226575 years and in 28.2% of younger patients (p=0.080). Although elderly patients demonstrated less favourable postoperative renal function and haemoglobin levels, no significant differences in overall complication rates were observed. On multivariable analysis, age was not independently associated with postoperative morbidity. Conversely, greater stone volume (OR 1.1, p<0.001) and longer operative time (OR 1.2, p<0.01) were independent predictors of complications. Mini-PCNL was associated with a significantly lower risk of postoperative adverse events (OR 0.37, p=0.001).
\nConclusions: Patients aged 75 years and older achieved stone-free and complication rates comparable to those observed in younger individuals despite a greater comorbidity burden and less favourable baseline clinical characteristics. Surgical complexity rather than chronological age emerged as the main determinant of postoperative morbidity. The protective effect observed with mini-PCNL further supports the adoption of minimally invasive percutaneous approaches in appropriately selected elderly stone formers.<\/p>","protected":false},"excerpt":{"rendered":"
Introduction & Objectives: As life expectancy increases, the number of elderly patients requiring surgical treatment for nephrolithiasis continues to rise. Although percutaneous nephrolithotomy (PCNL) remains the reference treatment for large and complex renal stones, concerns persist regarding its safety in … read more<\/a><\/p>","protected":false},"author":3,"featured_media":351,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-350","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/350","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/351"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=350"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=350"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=350"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}