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<p>The objective of this study was to perform a multi-centre and global study evaluating the clinical outcomes and complications associated with of URS for stone disease in patients aged 80 years and above. Retrospective analysis was conducted on patients aged ≥ 80 years who underwent URS for stone disease between January 2014 and December 2024, across 20 centres in 14 countries.&#xa0;A total of 679 patients aged ≥ 80 years underwent ureteroscopy (URS), with a median age of 83 years (IQR 81–86) and a male-to-female ratio of 1.2:1. Most patients were ASA grade 2 (52%) and presented electively (95%), with general anaesthesia used in 77% of cases. The median cumulative stone size was 11&#xa0;mm (IQR 7–15), and 56% had a single stone. The overall stone-free rate (SFR) was 70% for zero fragments, increasing to 84% when including fragments ≤ 2&#xa0;mm, and 90% when including fragments ≤ 4&#xa0;mm. The overall 30-day complication rate was 16%, with major complications (Clavien-Dindo grade ≥ 3) in 2.8% of patients. The most common complication was urinary tract infection (9.4%). One procedure-related death (0.1%) was recorded. Multivariable analysis identified ASA score ≥ 3 (OR 1.60), operative time &gt; 60&#xa0;min (OR 1.73), and emergency surgery (OR 2.96) as independent predictors of complications. Ureteroscopy can be performed in patients aged 80 years and above with a low risk of major complications and acceptable stone clearance rates. Avoiding both emergency surgery and prolonged operative times can help reduce the morbidity profile.</p>

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Ureteroscopy for stone disease in the elderly (≥ 80 years): Outcomes of a multicentre study from YAU and EAU endourology groups

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月18日

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  • Lazaros Tzelves,
  • Bhaskar Somani,
  • Steffi Kar Kei Yuen,
  • Vineet Gauhar,
  • Smita De,
  • Amelia Pietropaolo,
  • Daniele Castellani,
  • Deepak Ragoori,
  • Esteban Emiliani,
  • Eugenio Ventimiglia,
  • Arman Tsaturyan,
  • Tarik Emre Sener,
  • Maria Florencia Frascheri,
  • Alba Sierra,
  • Francesco Esperto,
  • Łukasz Nowak,
  • Vincent De Coninck,
  • Ioannis Mykoniatis,
  • Alberto Olivero,
  • Rifat Burak Ergül,
  • Begoña Ballesta Martinez,
  • Alejandro Bautista-Perez-Gavilan,
  • Sahil Patel,
  • Eric Villalba,
  • Qasim Seyidov,
  • Joren Vanthoor,
  • Stavros Tsiakaras,
  • Panagiotis Triantafyllou,
  • Arianna Pischetola,
  • Luca Villa,
  • Paola Arena,
  • Øyvind Ulvik,
  • Mathias S. Æsøy,
  • Peder Gjengstø,
  • Ali Talyshinskii,
  • Christian Beisland,
  • Patrick Juliebø-Jones

摘要

The objective of this study was to perform a multi-centre and global study evaluating the clinical outcomes and complications associated with of URS for stone disease in patients aged 80 years and above. Retrospective analysis was conducted on patients aged ≥ 80 years who underwent URS for stone disease between January 2014 and December 2024, across 20 centres in 14 countries. A total of 679 patients aged ≥ 80 years underwent ureteroscopy (URS), with a median age of 83 years (IQR 81–86) and a male-to-female ratio of 1.2:1. Most patients were ASA grade 2 (52%) and presented electively (95%), with general anaesthesia used in 77% of cases. The median cumulative stone size was 11 mm (IQR 7–15), and 56% had a single stone. The overall stone-free rate (SFR) was 70% for zero fragments, increasing to 84% when including fragments ≤ 2 mm, and 90% when including fragments ≤ 4 mm. The overall 30-day complication rate was 16%, with major complications (Clavien-Dindo grade ≥ 3) in 2.8% of patients. The most common complication was urinary tract infection (9.4%). One procedure-related death (0.1%) was recorded. Multivariable analysis identified ASA score ≥ 3 (OR 1.60), operative time > 60 min (OR 1.73), and emergency surgery (OR 2.96) as independent predictors of complications. Ureteroscopy can be performed in patients aged 80 years and above with a low risk of major complications and acceptable stone clearance rates. Avoiding both emergency surgery and prolonged operative times can help reduce the morbidity profile.