Supplementary Material

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Backround: To assess the safety and effectiveness of percutaneous nephrolithotomy (PCNL) in aging patients.

Methods: The records of patients who underwent PCNL were retrospectively evaluated from our database. The patients were divided into three age groups, ≤ 49 years (Group 1), 50-69 years (Group 2), and ≥ 70 years (Group 3). Baseline characteristics, outcomes, and complications were then compared between the groups. The modified Clavien classification was used for reporting complications. Achieving stone-free status or a residual stone size ≤ 4 mmwere regarded as representing surgical success.

Results: Four hundred forty-three PCNL operations were performed between January 2015 and January 2020.Mean stone sizes were similar in the three groups, 508.7 ± 320.7mm^2 in Group 1, 494.7 ± 314.1mm^2 in Group 2, and 526.9 ± 328.4mm^2 in Group 3 (p = 0.61). Comorbidities were observed in 6.1% of the patients in Group 1, 39.2% of those in Group 2, and 87.2% of those in Group 3. The level of accompanying comorbidities in Group 1 was significantly lower than in the other two groups (p < 0.001). The overall stone clearance rate was 81.5%, and the complication rate requiring invasive procedures was 16.5%. Mean operative time, access number, postoperative hemoglobin drop, nephrostomy removal time, length of hospital stay, and complication and success rates were similar between all three groups (p > 0.05).

Conclusion: These results indicate that PCNL is a safe and effective method in aging patients.