The application of S.T.O.N.E. nephrolithometry in pediatric patients with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy

Abstract

The purpose of this study is to verify the applicability of S.T.O.N.E. nephrolithometry in pediatric patients. 103 cases of pediatric patients younger than 4 years old with upper urinary tract calculi treated with mini-percutaneous nephrolithotomy from January 2012 to March 2014 were retrospectively reviewed and evaluated using this scoring system. All procedures were performed under general anesthesia, using a 14-French nephroscope through a 16-French working access. All patients were divided into two groups according to the stages of the operations, Group A for one-stage operation and Group B for two-stage operation. 87 cases were male and 16 cases were female with the mean age of 26.5 months. The total operation time of group A was 45.89±5.43 min, and 54.62±5.58 min of group B (p=0.000). The hospitalization for group A and group B was 6.63±1.34 and 7.23±1.24 days, respectively (p=0.134). The total S.T.O.N.E. score was 5.93±0.67 for Group A, and 7.92±1.04 for Group B (p=0.000). On further dividing each group into low/moderate/high complexity according to the total score, more cases of low/moderate complexity in group A and more cases of moderate/high complexity in group B (χ2=38.096, p=0.000) were reported. Our data suggest that S.T.O.N.E. nephrolithometry is applicable in pediatric upper urinary tract calculi assessment and predictive for the complexity of the operation, hospitalization, and even complications after the operation. Yet modification may be necessary to make this scoring system more distinguishable for pediatric cases.

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

“…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%.…”

“…Okhunov et al 8 found estimated blood loss, length of hospital stay, and operation time to be significant. Doulian et al 29 applied S.T.O.N.E. nephrolithometry score to the pediatric age group and found that the estimated blood loss and length of hospital stay were insignificant.…”

Prediction of Pediatric Percutaneous Nephrolithotomy Outcomes Using Contemporary Scoring Systems

“…Pediatric patients have a small renal reserve and quietly feeble renal parenchyma, therefore pediatric PCNL can be a life threatening procedure. Mini-PCNL using 14 French to 16 French working tract, is effective and safe for pediatric renal stones management 22 .…”

“…To our knowledge, there is a relative lack of studies evaluating these scoring systems in pediatrics. 16 in children with upper urinary tract stones managed by mini-PCNL. The authors concluded that (S.T.O.N.E.…”

“…In a recent study Utangac et al 15 compared GSS and CROES scoring system in pediatric Mini-PCNL. Doulian et al 16 No previous study has compared the three scoring systems to predict the SFR in the same cohort of pediatric patients. The aim of our study was to compare the GSS, CROES and S.T.ON.E.…”