Table 2.
Intraoperative and postoperative outcomes
| Group 1 age 75–79 years N = 189 | Group 2 age 80–84 years N = 113 | Group 3 age ≥ 85 N = 64 | p value | |
|---|---|---|---|---|
| Type of anesthesia, n (%) | 0.129 | |||
| Spinal anesthesia | 9 (4.8) | 4 (3.5) | 1 (1.6) | |
| General anesthesia | 180 (95.2) | 109 (96.5) | 63 (98.4) | |
| Respiratory control, n (%) | 0.730 | |||
| None | 87 (48.3) | 49 (45.0) | 31 (49.2) | |
| Gated | 28 (15.6) | 19 (17.4) | 12 (19.0) | |
| Apneic | 65 (36.1) | 41 (37.6) | 20 (31.8) | |
| Semirigid URS before RIRS, n (%) | 73 (38.6) | 51 (45.1) | 36 (56.3) | 0.036 |
| Urethral access sheath size, n (%) | 0.105 | |||
| ≤ 8 Fr | 15 (7.9) | 20 (17.7) | 8 (12.5) | |
| > 8 Fr | 147 (77.8) | 76 (67.3) | 44 (68.8) | |
| No use of sheath | 27 (14.3) | 17 (15.0) | 12 (18.8) | |
| Ureteroscope type, n (%) | 0.265 | |||
| Reusable | 152 (80.4) | 95 (84.1) | 57 (89.1) | |
| Disposable | 37 (19.6) | 18 (15.9) | 7 (10.9) | |
| Size of ureteroscope tip, n (%) | 0.076 | |||
| 7 Ch | 1 (0.5) | 2 (1.8) | 0 (0) | |
| 7.5 Ch | 69 (36.5) | 33 (29.2) | 15 (23.4) | |
| 7.6 Ch | 1 (0.5) | 5 (4.4) | 1 (1.6) | |
| 8 Ch | 1 (0.5) | 0 (0) | 2 (3.1) | |
| 8.5 Ch | 36 (19.0) | 19 (16.8) | 15 (23.4) | |
| 9 Ch | 52 (27.5) | 38 (33.6) | 24 (37.5) | |
| 9.5 Ch | 8 (4.5) | 6 (5.3) | 2 (3.1) | |
| Missing | 21 (11.0) | 10 (8.8) | 5 (7.8) | |
| Type of laser, n (%) | 0.261 | |||
| Holmium laser | 162 (85.7) | 104 (92.0) | 56 (87.5) | |
| Thulium fiber laser | 27 (14.3) | 9 (8) | 8 (12.5) | |
| Power of holmium machine, n (%) | 0.286 | |||
| < 30W | 49 (30.2) | 42 (40.4) | 19 (29.7) | |
| > 30W | 113 (69.8) | 62 (59.6) | 45 (70.3) | |
| Lithotripsy technique*, n (%) | 0.416 | |||
| Dusting | 67 (35.4) | 34 (30.1) | 17 (26.6) | |
| Popcorning | 49 (25.9) | 22 (19.5) | 14 (21.9) | |
| Fragmentation | 34 (18.0) | 23 (20.4) | 10 (15.6) | |
| Combination | 137 (72.5) | 80 (70.8) | 51 (79.7) | |
| Extraction of fragments with a basket&, n (%) | 64 (33.9) | 45 (39.8) | 34 (53.1) | 0.030 |
| Laser time, minutes, mean (standard deviation) | 20 (13–34.5) | 24 (17–47.5) | 35 (14–50) | 0.266 |
| Operation time, minutes, median (IQR) | 55 (42–80) | 60 (39–104) | 55 (35–84) | 0.278 |
| Intraoperative complications&, n (%) | ||||
| Pelvicalyceal system bleeding not requiring blood transfusion | 3 (1.6) | 1 (0.9) | 2 (3.1) | 0.188 |
| Ureteric injury due to access sheath requiring stenting | 2 (1.1) | 2 (1.8) | 1 (1.6) | 0.866 |
| Postoperative stay, days, median (IQR) | 2.5 (2.0–9.0) | 2.0 (2.0–8.25) | 6.0 (2.0–9.0) | 0.043 |
| Day surgery&, n (%) | 15 (7.9) | 11 (9.7) | 3 (4.7) | 0.138 |
| Postoperative complications&, n (%) | ||||
| Fever/Infections requiring antibiotics (Clavien grade 2) | 12 (6.3) | 4 (3.5) | 3 (4.7) | 0.550 |
| Hematuria requiring blood transfusions (Clavien grade 2) | 4 (2.1) | 3 (2.6) | 1 (1.6) | 0.190 |
| Sepsis requiring ICU admission (Clavien Grade 4) | 8 (4.2) | 2 (1.8) | 1 (1.6) | 0.422 |
| Type of stone, n (%) | n = 73 | n = 52 | n = 34 | – |
| Uric acid | 10 (13.7) | 7 (13.5) | 2 (5.9) | |
| Calcium oxalate monohydrate | 29 (39.7) | 22 (42.3) | 11 (32.4) | |
| Calcium oxalate dihydrate | 9 (12.3) | 9 (17.3) | 6 (17.6) | |
| Struvite | 1 (1.4) | 5 (9.6) | 3 (8.8) | |
| Mixed | 24 (32.9) | 9 (17.3) | 12 (35.3) | |
| Post-operative imaging assessment bya, n (%) | 0.298 | |||
| CT scan | 40 (21.2) | 30 (26.5) | 16 (25.0) | |
| X-ray | 87 (46.0) | 47 (41.6) | 36 (56.3) | |
| Ultrasound | 80 (40.0) | 36 (31.9) | 29 (45.3) | |
| Combination | 72 (38.1) | 37 (32.7) | 29 (45.3) | |
| Residual fragments ≥ 4 mm&, n (%) | 42 (22.2) | 30 (26.5) | 14 (21.9) | 0.650 |
| Ancillary treatment for residual fragments& n (%) | n = 42 | n = 30 | n = 14 | 0.679 |
| SWL | 2 (4.8) | 1 (3.3) | 0 (0) | |
| RIRS | 5 (11.9) | 9 (30.0) | 2 (14.3) | |
| PCNL | 5 (11.9) | 0 (0) | 0 (0) | |
| ECIRS | 0 (0) | 1 (3.3) | 1 (7.1) | |
| Observation alone | 30 (71.4) | 19 (63.4) | 11 (78.6) | |
Bold value stands for significant p value
IQR interquartile range, different locations
aMore than one choice possible
&Fisher’s test