scholarly journals Evaluation and Comparison of Predictive Efficiency of S.T.O.N.E. and CROES Nephrolithometry Scoring Systems in Percutaneous Nephrolithotomy

2020 ◽  
Author(s):  
Erhan Ateş
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Scoring System ◽  
Operation Time ◽  
Hounsfield Unit ◽  
Scoring Systems ◽  
Renal Stones ◽  
Stone Burden ◽  
Preoperative Ct ◽  
The Mean ◽  
Free Status

INTRODUCTION: Currently, there is no consensus on an ideal predictive model that characterizes the complexity of renal stones and predicts surgical results after percutaneous nephrolithotomy (PCNL). The aim of this study is to compare the accuracy of the S.T.O.N.E.nefrolithometry scoring system and CROES nephrolithometric nomogram in predicting stone-free rate and complications of PCNL results. METHODS: Data from 50 renal units (45 patients) who underwent PCNL operation by the same surgeon between March 2016 and January 2019 for > 2 cm kidney stones were retrospectively analyzed. Preoperative clinical and radiological data and postoperative features of the patients were recorded. Postoperative complications were classified according to the modified Clavien scoring system. S.TO.N.E. and CROES nephrolithometry scores were calculated on preoperative CT images for each patient, and their relationship with stone-free status and complications was evaluated by logistic regression analysis. RESULTS: The mean stone burden was 778.6 ± 665.4 mm2, the mean Hounsfield Unit was 990.6 ± 335.1 HU, the mean operation time was 125 ± 34 minutes, the mean hospitalization time was 4.7 ± 2.71 days. The mean S.T.O.N.E score was 8.76 ± 2.03, and the mean CROES score was 134.26 ± 67.36. Complete stone-free was achieved in 21 (42%) of the cases. In cases with residual stones, the stone burden was statistically significantly higher compared to cases without stone-free (p = 0,000). There is a positive correlation between the S.T.O.N.E. score and the operation time (r = 0.487, p = 0.000). But, there was a negative correlation between the operation time with the CROES score (r = -0.514, p = 0.000) and the nephrostomy time (r = -0.29, p = 0.04). The relationship between both scoring systems and stone-free rates were statistically significant (p = 0,000). There was a statistically significant relationship between the presence of complications and only the CROES scoring system (p = 0.032). DISCUSSION AND CONCLUSION: S.T.O.N.E. and CROES scoring systems have predictive value for stone-free status after PCNL. The CROES nephrolithometry nomogram is more effective in predicting complications after PCNL.

Percutaneous nephrolithotomy of staghorn renal stones in pediatric patients using adult-sized instrument

2019 ◽  
Vol 86 (4) ◽  
pp. 211-215
Author(s):  
Akbar Nouralizadeh ◽  
Hamid Pakmanesh ◽  
Abbas Basiri ◽  
Mohammad Hadi Radfar ◽  
Behzad Narouie ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Pediatric Patients ◽  
Renal Stones ◽  
Adult Size ◽  
Efficacy And Safety ◽  
Double J Stent ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate ◽  
Free Status

Introduction: In this study, we aimed to evaluate the safety and efficacy of the percutaneous nephrolithotomy procedure performed with adult-sized instruments in pediatric cases with staghorn kidney stone. Methods: We retrospectively evaluated the efficacy and safety of 94 percutaneous nephrolithotomy procedures performed during 15 years in a single center for 82 pediatric patients with staghorn calculi using adult-sized instruments (24-Fr nephroscope). Stone free status was defined as complete clearance of the stones or the presence of insignificant residual stones of <3 mm in diameter. Results: The mean age was 108 ± 53 months (range, 14–180 months). There were 39 patients (48%) with complete staghorn stones and 43 cases (52%) with partial staghorn. We fulfilled 91.4% of operations through a single access. The stone free rate was 86.6% after one percutaneous nephrolithotomy session. In total, seven patients referred for shock wave lithotripsy and four cases were scheduled for the second percutaneous nephrolithotomy session. Fever occurred in 18 patients (21%) and bleeding requiring transfusion in four children (5%). Prolonged leakage from nephrostomy site requiring anesthesia for double J stent placement occurred in one patient. No grade IV or V Clavien complication occurred. Conclusion: The success rate and complications of percutaneous nephrolithotomy with adult-size instruments in pediatric patients are acceptable.

scholarly journals Comparison of STONE score with Guy’s stone score as a tool to predict stone clearance rates in patients undergoing percutaneous nephrolithotomy: a single center study

2020 ◽  
Vol 8 (1) ◽  
pp. 339
Author(s):  
Anoop Handa ◽  
Sharat Chandra Dash ◽  
Nimit Solanki ◽  
Abhishek Shukla ◽  
Gagandeep Singh ◽  
...  
Keyword(s):  
Blood Loss ◽  
Percutaneous Nephrolithotomy ◽  
Predictive Accuracy ◽  
Operating Time ◽  
Scoring Systems ◽  
Single Center Study ◽  
Stone Free Rate ◽  
The Mean ◽  
The Relationship ◽  
Free Status

Background: We aimed to compare the Guy’s stone score and STONE nephrolithometry score and assess their predictive accuracy for percutaneous nephrolithotomy (PCNL) outcomes.  Methods: A total of 100 patients, who underwent PCNL between Jan 2018 and Dec 2018 were included in the study. All patients were evaluated with computerized tomography (CT) scan preoperatively and scores were calculated. Patient demographic characteristics, intraoperative and postoperative variable were evaluated. The relationship between the Guy’s and STONE scores, and their prediction for postoperative stone-free status, complications were compared. Results: The mean Guy’s score was 2.04±1.01, and the mean STONE score was 8.0+1.7. The mean operative time was 101.9+41 minutes and the mean blood loss was 170+113ml. The complication rate in our study was found to be 32%, majority were grade 1-2. Both scoring systems showed positive correlation with stone burden, operating time and blood loss. The overall stone free rate was 72% and both the GSS and STONE score were significantly associated with success of the procedure.  Conclusions: Both Guy’s and STONE scoring systems are equally effective in predicting stone-free status.  

scholarly journals Retrograde Intrarenal Surgery vs. Miniaturised Percutaneous Nephrolithotomy to Treat Lower Pole Renal Stone < 2 cms Diameter in Western Part of Odisha

2021 ◽  
Vol 8 (19) ◽  
pp. 1347-1351
Author(s):  
Ashok Kumar Nayak ◽  
Sanjay Kumar Mahapatra ◽  
Braja Mohan Mishra ◽  
Dipti Ranjan Dhar ◽  
Biswajit Sahu
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operating Time ◽  
Operation Time ◽  
Renal Stones ◽  
Analysis Data ◽  
Lower Pole ◽  
Medical Sciences ◽  
Retrograde Intrarenal Surgery ◽  
The Mean

BACKGROUND We wanted to compare the outcomes of retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mini-PCNL) in treating lower pole (LP) renal stones with a diameter of < 2 cm in terms of safety, efficacy, and stonefree rate (SFR). METHODS In a retrospective analysis data of 39 patients who underwent mini-PCNL (N = 19) or RIRS (N = 20) for LP stones with a diameter of < 2 cm were reviewed between November 2018 and November 2020 at the Department of Urology in Veer Surendra Sai Institute of Medical Sciences and Research (VSSIMSAR), Odisha. The mean age, sex, stone size, operating time, complications, hospital stay, and SFR were compared between the groups. The success of the procedure was defined as the absence of residual stones or small residuals of size 3mm or less on computed tomography at 12 weeks postoperatively. RESULTS Significant differences were found in the hospital stay duration in hours (103.3 ± 11.7 vs. 145.2 ± 16.4, P < 0.028) between the RIRS and mini - PCNL groups. The mean operation time (in minutes) was also significantly different between the RIRS group (82.5 ± 3.44) and mini PCNL group (86.21 ± 5.90, P = 0.021). The stonefree rates in the postoperative period at three months (RIRS vs. mini - PCNL: 95 % vs. 94 %, P = 0.47) were not significantly different. CONCLUSIONS RIRS and mini-PCNL are both safe and effective methods for treating LP stones with a diameter of < 2 cm. RIRS can be considered as a less invasive alternative to PCNL for the treatment of LP stones of < 2 cm with reasonable SFR with shorter hospital stay. KEYWORDS Retrograde Intrarenal Surgery, Percutaneous Nephrolithotripsy, Lower Pole Kidney Stones, Miniaturized Percutaneous Nephrolithotomy

scholarly journals Prediction of Surgical Outcome after Percutaneous Nephrolithotomy through Guy’s Score and Nephrolithometric Nomogram

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K A Teama ◽  
M I Shabayek ◽  
T I S Aly
Keyword(s):  
Quality Of Life ◽  
Percutaneous Nephrolithotomy ◽  
Scoring Systems ◽  
Renal Stones ◽  
University Hospitals ◽  
Stone Clearance ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate

Abstract Background Urolithiasis has a well documented common occurrence in the general population. Percutaneous nephrolithotomy (PCNL), has prevailed over other more morbid procedures, like open surgeries in the management of such stones PNL in complex renal stones is a challenging procedure because it requires considerable experience in gaining percutaneous tracts, performing delicate and judicious intrarenal manipulations, mastering all techniques of intracorporeal stone disintegration, and weighing the benefits of complete stone clearance against the risks of complications. Aim of the Work GSS and Nephrolithometric Nomogram. Scoring system in predicting PCNL outcomes. The ability of the GSS and STONE score to correlate with the post-operative change in the quality of life. Patients and Methods In a non-randomized prospective study we evaluated the two scoring systems Guy’s and S.T.O.N.E. nephrolithometry scoring systems in predicting the success rate of PCNl and the quality of life. This study included 100 patients with renal stones who were scheduled for PCNL at El Demerdash University Hospitals and Nasser institute hospital in the period from April 2017 to October 2018. Results Our study included 100 patients (34 were female, 66 were male) with a mean age of 46.16 (range from 28 to 68). The mean GUY score was 1.57± 0.73 and the mean STONE score was 5.76± 1.19.the overall stone free rate was 89% with a complication rate of 18% with a mean stone burden &lt;400 mm.GUY and STONE score were able to predict SFR and complications after PCNL. Conclusion Both GSS and S.T.O.N.E Nephrolithometry Score can be used to stratify the complexity of renal stone before PCNL to predict the stone clearance and complication. Both can be valuable tools for providing uniformity for comparison of outcome, proper planning of the surgery and preoperative counseling of the patient.

scholarly journals Initial Experience of Percutaneous Nephrolithotomy at Lumbini Medical College

2013 ◽  
Vol 1 (1) ◽  
pp. 35
Author(s):  
Prakash Sapkota ◽  
Y B Tambey ◽  
Sunil Thapa ◽  
Rajan Shakya
Keyword(s):  
Prospective Study ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Renal Stones ◽  
Invasive Approach ◽  
Medical College ◽  
Stone Burden ◽  
Estimated Blood Loss ◽  
The Mean

  Introduction: Renal stone disease is a challenging problem in urologic practice especially in our locality because of large stone burden and recurrence. Since ,the early 1980s when percutaneous nephrolithotomy (PCNL) was established for management of renal stones, open surgical procedures have virtually been replaced. PCNL is a safe, effective and minimally invasive approach compared to open surgery for patients with large single, multiple or staghorn stones. The aim of this prospective study was to evaluate and to review our experience with PCNL in management of renal and upper ureteric stones.   Methods: Prospective study carried out at Lumbini Medical College and Teaching Hospital during 1stJanuary 2011 to 31st October 2011. Sixty patients were evaluated and subjected to PCNL. After clinical investigations like ultrasonography (USG) and intravenous urography (IVU), once patients were found to have renal or upper ureteric stones they were informed and explained about PCNL, its likely complications, probable hospital stay, the cost of treatment and data were recorded along with the operative time, estimated blood loss, stone burden, stone-free rate, length of hospitalization and complications .Patients were followed up after three months to rule out recurrence of stones by plain abdominal x-ray of kidney, ureter and bladder and USG.   Results: Out of 60 patients 35 were male and 25 were female (M: F=1.4:1) with mean age of 37 years and were subjected to PCNL monotherapy. With the average stone size of 3.26cm, the mean operative time was 78 minutes. Complete stone removal achieved by PCNL alone in 60 cases, with insignificant residual small stones we achieved 97% stone clearance rate. The mean hospital stay was 3.7 days. No Serious complications were encountered, 9 (15%) patients required blood transfusion and 3 (5%) patients developed transient post-operative pyrexia.   Conclusion: PCNL is the first line treatment option for management of large renal stones which as monotherapy has advantages in removal of renal and upper ureteric stones and achieving excellent results with minimal morbidity.

scholarly journals Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Size ◽  
Intraoperative Complication ◽  
Safety And Efficacy ◽  
Single Center Experience ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

scholarly journals External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cong Wang ◽  
ShouTong Wang ◽  
Xuemei Wang ◽  
Jun Lu
Keyword(s):  
Scoring System ◽  
Kidney Stone ◽  
Medical Center ◽  
External Validation ◽  
Retrograde Intrarenal Surgery ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Stone Density ◽  
Free Rate ◽  
Free Status

Abstract Background The R.I.R.S. scoring system is defined as a novel and straightforward scoring system that uses the main parameters (kidney stone density, inferior pole stones, stone burden, and renal infundibular length) to identify most appropriate patients for retrograde intrarenal surgery (RIRS). We strived to evaluate the accuracy of the R.I.R.S. scoring system in predicting the stone-free rate (SFR) after RIRS. Methods In our medical center, we retrospectively analyzed charts of patients who had, between September 2018 and December 2019, been treated by RIRS for kidney stones. A total of 147 patients were enrolled in the study. Parameters were measured for each of the four specified variables. Results Stone-free status was achieved in 105 patients (71.43%), and 42 patients had one or more residual fragments (28.57%). Differences in stone characteristics, including renal infundibulopelvic angle, renal infundibular length, lower pole stone, kidney stone density, and stone burden were statistically significant in patients whether RIRS achieved stone-free status or not (P < 0.001, P: 0.005, P < 0.001, P < 0.001, P: 0.003, respectively). R.I.R.S. scores were significantly lower in patients treated successfully with RIRS than patients in which RIRS failed (P < 0.001). Binary logistic regression analyses revealed that R.I.R.S. scores were independent factors affecting RIRS success (P = 0.033). The area under the curve of the R.I.R.S. scoring system was 0.737. Conclusions Our study retrospectively validates that the R.I.R.S. scoring system is associated with SFR after RIRS in the treatment of renal stones, and can predict accurately.

scholarly journals A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2 cm

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Janak Desai ◽  
Guohua Zeng ◽  
Zhijian Zhao ◽  
Wen Zhong ◽  
Wenzhong Chen ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Urinary Calculi ◽  
Renal Stones ◽  
Laser Lithotripsy ◽  
Complication Rates ◽  
Modified Technique ◽  
Average Operative Time ◽  
Grade Ii ◽  
The Mean ◽  
Metal Sheath

Objectives. To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6 Fr mininephroscope through an 11–13 Fr metal sheath to perform holmium: YAG laser lithotripsy.Methods. The medical records of 36 patients with moderate-sized (<20 mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status.Results. The mean stone size was 14.9 ± 4.1 mm (rang: 6–20). The average operative time was 59.8 ± 15.9 (30–90) min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2–5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion.Conclusions. UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

scholarly journals Risk Factors for Postoperative Complications after Percutaneous Nephrolithotomy

2018 ◽  
Vol 16 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parash Mani Shrestha ◽  
Bishwa Raj Joshi
Keyword(s):  
Postoperative Complications ◽  
Percutaneous Nephrolithotomy ◽  
Scoring System ◽  
Operative Time ◽  
Standard Technique ◽  
Diabetic Patients ◽  
Staghorn Calculi ◽  
Stone Burden ◽  
Major Complications ◽  
A Prospective Study

Background: To identify the perioperative factors associated with complications after percutaneous nephrolithotomy by classification of complications according to the modified Clavien scoring system and evaluation of the minor and major complications related to the procedure.Methods: A prospective study of all the percutaneous nephrolithotomy performed by standard technique within 1.5 years at Bir Hospital was made. Possible demographic, preoperative and intraoperative variables were included in the study and patients were followed up postoperatively for any complications. All complications were classified according to modified Clavien scoring system and analyzed to identify the prognostic variables.Results: Two hundred and forty six percutaneous nephrolithotomy done within the study period were analyzed. Although 41.06 % of the study population developed complications, only 9.35 % had major complications. Age, body mass index, gender, clinical presentation, history of previous surgery and ASA score did not correlate with complications. Diabetes was the only comorbidity associated (p = 0.0482). Preoperatively estimated stone burden (p = 0.0023), number of calyces involved by the stones (p = 0.0002), and presence of staghorn calculi were significantly associated with development of postoperative complications. Multiple tracts were required (p = 0.0151) and operative time was longer (p < 0001) in the patients who developed complications.Conclusions: Percutaneous nephrolithotomy has lesser complications. Diabetic patients are more prone to develop complications. Larger stone burden, involvement of multiple calyces by stones and staghorn calculi are associated with need of multiple tracts and longer operative time, thus predisposing to higher incidence of complications.

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