Prediction of Pediatric Percutaneous Nephrolithotomy Outcomes Using Contemporary Scoring Systems

Aldaqadossi, Hussein; Salem, Hosni; Kotb, Yousef; Hussein, Hussein Aly; Shaker, Hossam; Δικαίος, Νικόλαος

doi:10.1016/j.juro.2017.04.084

Cited by 18 publications

(13 citation statements)

References 27 publications

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“…Several studies 20,21 have evaluated the applicability of the contemporary PCNL scoring systems of adults in pediatric patients and found that the S.T.O.N.E. score and Guy's score demonstrated the greatest accuracy in predicting SFR and CR, respectively.…”

Section: Discussionmentioning

confidence: 99%

Nomograms predicting the outcomes of endoscopic treatments for pediatric upper urinary tract calculi

Zhang

et al. 2020

Int J of Urology

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Objectives To demonstrate the efficacy and safety of mini‐percutaneous nephrolithotomy, micro‐percutaneous nephrolithotomy, and flexible ureteroscopy for pediatric upper urinary tract calculi and to develop nomograms predicting surgical outcomes. Methods A prospectively managed database containing children who were diagnosed with upper urinary tract calculi and treated with mini‐percutaneous nephrolithotomy, micro‐percutaneous nephrolithotomy, and flexible ureteroscopy between June 2014 and April 2019 was analysed. Patient demographics, intraoperative data, stone characteristics, stone‐free rate, and complication rate were analysed and compared. Nomograms predicting the postoperative stone‐free rate and complication rate were established based on predictors, and internal validation was performed. Calibration curves and decision curves were generated to assess the predictive efficacy and clinical benefit. Results Forty‐three children underwent mini‐percutaneous nephrolithotomy on 56 sides in 47 operations, 30 children underwent micro‐percutaneous nephrolithotomy on 30 sides in 30 operations, and 275 children underwent flexible ureteroscopy on 320 sides in 288 operations. The stone‐free rates were 88.5% (282/320) for flexible ureteroscopy, 89.3% (50/56) for mini‐percutaneous nephrolithotomy, and 90.0% (27/30) for micro‐percutaneous nephrolithotomy (P = 0.94). And the complication rates were 19.8% (57/288), 36.2% (17/47), and 33.3% (10/30), respectively (P = 0.02). Nomograms based on stone characteristics, operation duration, and the physical condition of the child were shown to have good discrimination and calibration. The area under the curve of the models was 81% for stone‐free rate and 73% for complication rate. The calibration curves showed that the nomogram might underestimate the probability of stone‐free rate when the threshold was below 82% and might overestimate the risk of complication rate when the threshold was over 25%. The decision curves demonstrated that the Capital Medical University nomograms improved clinical risk prediction against threshold probabilities of stone‐free rate ≤20% and complication rate ≤10%. Conclusions Both the percutaneous nephrolithotomy and flexible ureteroscopy procedures could have acceptable stone‐free rates when treating pediatric stones. The Capital Medical University nomograms performed well in helping to predict stone‐free and complication rates.

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Section: Discussionmentioning

confidence: 99%

Nomograms predicting the outcomes of endoscopic treatments for pediatric upper urinary tract calculi

Zhang

et al. 2020

Int J of Urology

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“…Of the patients, 58.3% were male and 41.7% were female. The mean BMI value was 27.2 (23)(24)(25)(26)(27)(28)(29)(30)(31) kg/m 2 . There was hypertension in 35% of the patients and diabetes mellitus in 25%.…”

Section: Resultsmentioning

confidence: 98%

Application of S.T.O.N.E. Nephrolithometry Score for Prediction of Stone-Free Status and Complication Rates in Patients Who Underwent Percutaneous Nephrolitotomy for Renal Stone

Danış

Polat

Bozkurt

et al. 2022

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Renal stone disease is a common disorder in urology practice. Kidney stone has various treatment methods such as extracorporeal shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy (PCNL). In this study, we aimed to determine the value of S.T.O.N.E. nephrolithometry score, which is considered as a new scoring system for predicting residual stone rate and complications in patients undergoing PCNL due to renal calculi. Materials and Methods: A total of 120 patients >18 years old who underwent PCNL were evaluated prospectively. Five parameters available from preoperative noncontrast-enhanced computed tomography were measured: stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E) and then S.T.O.N.E. nephrolithometry score was calculated. The prediction of the stone-free rates and complication rates of this scoring was evaluated statistically. Results: When the age, gender, body mass index, comorbidities, and American Society of Anesthesiologists scores of the patients were evaluated according to the patients' postoperative stone-free status, no statistical difference was found between the groups. Patients had a stone-free rate of 78%. Patients' mean neuropilitometry score was calculated to be 7.75 S.T.O.N.E. nephrolithometry score statistically significant (P = .001) for prediction of stone-free status. S.T.O.N.E. nephrolithometry score was significantly correlated with operation time, estimated blood loss, duration of fluoroscopy, duration of hospital stay, and number of punctures. Complications were seen in 13 patients. Conclusions: S.T.O.N.E. nephrolithometry score can be used as an objective criterion for predicting the complexity of the PCNL process. In addition, this scoring system is expected to provide more objective preoperative counseling and can provide standardization in academic studies.

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“…( p < 0.001 with an AUC of 0.671), and GSS ( p = 0.019 with an AUC of 0.629) on multivariate logistic regression analysis [26]. Recent studies evaluating the predictive value of stone scoring systems among special patient groups, such as pediatric patients and those with obesity, staghorn stones, and chronic kidney disease, revealed controversial results [27-30]. Taking this into account, we believe that the efficacy of stone scoring systems differs among patients with special conditions.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Factors Related to Percutaneous Nephrolithotomy Failure in Horseshoe Kidneys and Comparison of Three Stone Scoring Systems in Prediction of Outcomes

et al. 2020

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Introduction: We aimed to identify factors affecting percutaneous nephrolithotomy (PNL) outcomes among patients with horseshoe kidney (HSK) and assess the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES), Guy’s Stone Score (GSS), and S.T.O.N.E. scoring systems. Methods: Data from 98 patients with HSK who underwent PNL between November 2010 and January 2020 were evaluated. Patients were divided into the stone-free (SF) and non-SF groups and compared according to demographic data, stone and surgical characteristics, and stone scoring systems. Multivariate logistic regression analysis was performed to identify factors associated with SF status. Results: Among the included patients, 87 were male and 11 were female (mean age: 47.37 ± 14.42 years). The SF rate was 84.7% (83 patients). Group analysis identified GSS (p < 0.001), CROES score (p < 0.001), S.T.O.N.E. score (p = 0.014), stone burden (p = 0.045), and multiplicity (p < 0.001) as factors associated with SF status. Among our cohort, 10 patients developed complications. All scoring systems were significantly correlated with SF status (CROES: r = −0.442, p < 0.001; GSS: r = 0.442, p < 0.001; S.T.O.N.E.: r = 0.250, p = 0.013), while CROES score was identified as an independent factor associated with SF status (95% CI: 0.937–0.987; p = 0.003). Conclusions: PNL is an effective method for treating nephrolithiasis among patients with HSK. Moreover, stone-related factors, such as larger size, multiplicity, and complexity, were associated with procedural failure. Finally, the CROES nomogram was a better predictor of SF status compared with other scoring systems.

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Prediction of Pediatric Percutaneous Nephrolithotomy Outcomes Using Contemporary Scoring Systems

Cited by 18 publications

References 27 publications

Nomograms predicting the outcomes of endoscopic treatments for pediatric upper urinary tract calculi

Nomograms predicting the outcomes of endoscopic treatments for pediatric upper urinary tract calculi

Application of S.T.O.N.E. Nephrolithometry Score for Prediction of Stone-Free Status and Complication Rates in Patients Who Underwent Percutaneous Nephrolitotomy for Renal Stone

Investigation of Factors Related to Percutaneous Nephrolithotomy Failure in Horseshoe Kidneys and Comparison of Three Stone Scoring Systems in Prediction of Outcomes

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