Percutaneous nephrolithotomy in septuagenarians and older: Is it safe?

Objective: To evaluate the feasibility, safety, and effectiveness of percutaneous nephrolithotomy (PCNL) in patients over the age of 70 with large renal calculi. Methods: A retrospective study was conducted on patients over 70 who underwent PCNL between November 2009 and February 2020 by a single consultant surgeon. Data collected included patient demographics, stone characteristics, surgical details, and postoperative outcomes. Statistical analysis was performed using one-way ANOVA and Chi-square tests. Results: The study included 72 patients, with a mean age of 75. The overall stone clearance rate was 80.5%, with 33.3% of patients experiencing complications. The most common complications were postoperative fever (23.6%) and sepsis (6.9%). No significant differences in complication rates were observed across different age groups and Charlson Comorbidity Index (CCI) scores. Conclusion: PCNL is a feasible and relatively safe procedure for elderly patients. It demonstrates effective stone clearance with complication rates comparable to those reported in the literature. Careful planning and patient selection are crucial for optimising outcomes in this population. Level of evidence: 3