title: Effectiveness and Safety of Ureteroscopic Holmium Laser Lithotripsy for Upper Urinary Tract Calculi in Elderly Patients.
abstract: Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the '＜65 group' (＜65 years old, n＝108), the '65-74 group' (65-74 years old, n＝42), and the ' 75 group' ( 75 years old, n＝39). The patients' characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the 75 group had a significantly higher prevalence of hypertension compared to the＜65 group. Compared to the＜65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the 75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the 75 group were similar to those of the＜65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors.
authors.affiliation: Department of Urology, Abiko Toho Hospital, Abiko, Chiba 277-0005, Japan.ty5733@gmail.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Hideo
authors.initials: H
authors.lastname: Otsuki
authors.forename: Shinya
authors.initials: S
authors.lastname: Uehara
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Shimizu
authors.forename: Wataru
authors.initials: W
authors.lastname: Murao
authors.forename: Koji
authors.initials: K
authors.lastname: Fujio
authors.forename: Kei
authors.initials: K
authors.lastname: Fujio
authors.forename: Koichiro
authors.initials: K
authors.lastname: Wada
authors.forename: Motoo
authors.initials: M
authors.lastname: Araki
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Nasu
mesh_terms: D000368:Aged; D005260:Female; D006695:Holmium; D006801:Humans; D007431:Intraoperative Complications; D017602:Lithotripsy, Laser / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D018666:Ureteroscopy / Q000295:instrumentation* / Q000379:methods; D014545:Urinary Calculi / Q000601:surgery*
chemical_list: D006695:Holmium