Contemporary management of renal stones

Douglas-Moore, Jayne; Miller, Marek

doi:10.1002/tre.478

Cited by 1 publication

(1 citation statement)

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“…The estimated 5-year recurrence rate is up to 50% [2]. Amongst several surgical options, percutaneous nephrolithotomy (PCNL) has stood the test of time and is one of the main procedures performed by stone surgeons [3]. It has become the standard treatment for large and complex kidney stones [4].…”

Section: Introductionmentioning

confidence: 99%

Guy’s Stone Score as a Predictor for Stone-Free Rate and Complications in Percutaneous Nephrolithotomy: A Single-Center Report from a Stone Belt Country

Rashid

Khalid

Friad³

et al. 2020

Urol Int

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Objectives: To evaluate Guy's Stone Score (GSS) as a grading system for the complexity of renal calculi before percutaneous nephrolithotomy (PCNL) and as a predictor for stonefree rate (SFR) and potential complications in the setting of a developing country with many cases of advanced complex stone disease. Patients and Methods: We performed a prospective study on 115 patients with renal stones who had PCNL between August 2017 and October 2018. Stone complexity was classified according to GSS using preoperative imaging. The rates of perioperative complications were assessed using the Clavien grading system, and the SFR was assessed in the 3rd postoperative week by abdominal X-ray and renal ultrasound. The χ 2 and one-way ANOVA tests were used for statistical analysis. A p value ≤0.05 was considered significant. Results: The study included 115 patients (77 males) with a mean age of 50.2 (±13.3) years. Cases were classified according to GSS into 4 grades; there were 24 (20.9%) grade I, 48 (41.7%) grade II, 25 (21.7%) grade III, and 18 (15.7%) grade IV cases. There was a significant inverse correlation between GSS grade and SFR (p < 0.001). The rate of complications using the Clavien grading system were significantly higher in GSS grades III and IV (p = 0.002). So were the rates of blood transfusion, the need for > 1 access tract, and the duration of hospitalization. Conclusion: GSS is a simple and easily reproducible system to classify the complexity of renal stones. In our setting, it also proved an excellent tool to predict SFR, perioperative complications, and associated ancillary procedures. Ultimately, it can help surgeons and, above all, patients to make a more informed decision about their surgery.

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Section: Introductionmentioning

confidence: 99%