Does nephrolithometry scoring systems predict success and complications in miniPCNL?

Int Urol Nephrol. 2022 Jun;54(6):1207-1213. doi: 10.1007/s11255-022-03174-9. Epub 2022 Mar 15.

Abstract

Objective: Auxiliary nephrolithometric scoring systems (NSSs) have been developed to predict complications and treatment success of conventional percutaneous nephrolithotomy (PCNL). However, to our knowledge, there is no study comparing these NSSs in patients undergoing miniPCNL. This study aimed to compare the NSSs in terms of their ability to predict miniPCNL-related complications and treatment success.

Methods: The data of patients undergoing PCNL between September 2016 and May 2018 were retrospectively reviewed through the electronic medical record system, and 140 patients were included in our study. Stone-free status was evaluated using non-contrast computed tomography between 1 and 3 months after the procedure. PCNL was considered successful if the patient was completely stone free. The postsurgical complications were classified according to the modified Clavien-Dindo classification system.

Results: The Clinical Research Office of the Endourological Society (CROES) and STONE NSSs significantly predicted miniPCNL treatment success (p = 0.043, p = 0.018). However, the Guy's NSS did not significantly predict the treatment success (p = 0.415). Guy's, CROES and STONE NSSs were not found to significantly predict postsurgical complications (p = 0.584, p = 0.823, p = 0.189).

Conclusion: To the best of our knowledge, our study is the first of its kind to investigate the ability of NSSs to predict treatment success and postsurgical complications in patients undergoing miniPCNL. The study found that STONE and CROES NSSs are independent parameters for predicting stone-free status after miniPCNL. In addition, our study found that none of the NSSs were useful in predicting postsurgical complications in patients undergoing miniPCNL.

Keywords: CROES; GUY's; PCNL; STONE; Scoring systems; miniPCNL.

MeSH terms

  • Female
  • Humans
  • Kidney Calculi* / complications
  • Kidney Calculi* / diagnostic imaging
  • Kidney Calculi* / surgery
  • Length of Stay
  • Male
  • Nephrostomy, Percutaneous* / adverse effects
  • Operative Time
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome