The Guy's Stone Score—Grading the Complexity of Percutaneous Nephrolithotomy Procedures

Thomas, Kay; Smith, Naomi C.; Hegarty, Nicholas J.; Glass, Jonathan

doi:10.1016/j.urology.2010.12.026

Cited by 354 publications

(350 citation statements)

References 26 publications

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“…Inclusion criteria for patient selection were: age older than 18 yr; stone in the renal pelvis; stone size 2.5 cm; and Guy's stone score of 1-2 [12]. …”

Section: Patient Selection Criteriamentioning

confidence: 99%

Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)

et al. 2017

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E U R O P E A N U R O L O G Y X X X ( 2 0 1 7 ) X X X -X X X a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m Article info AbstractBackground: Puncture of the renal collecting system represents a challenging step in percutaneous nephrolithotomy (PCNL). Limitations related to the use of standard fluoroscopic-based and ultrasound-based maneuvers have been recognized. Objectives: To describe the technique and early clinical outcomes of a novel navigation system for percutaneous kidney access. Design, setting, and participants: This was a proof-of-concept study (IDEAL phase 1) conducted at a single academic center. Ten PCNL procedures were performed for patients with kidney stones. Surgical procedure: Flexible ureterorenoscopy was performed to determine the optimal renal calyx for access. An electromagnetic sensor was inserted through the working channel. Then the selected calyx was punctured with a needle with a sensor on the tip guided by real-time three-dimensional images observed on the monitor. Outcome measurements and statistical analysis: The primary endpoints were the accuracy and clinical applicability of the system in clinical use. Secondary endpoints were the time to successful puncture, the number of attempts for successful puncture, and complications. Results and limitations: Ten patients were enrolled in the study. The median age was 47.1 yr (30-63), median body mass index was 22.85 kg/m 2 (19-28.3), and median stone size was 2.13 cm (1.5-2.5 cm). All stones were in the renal pelvis. The Guy's stone score was 1 in nine cases and 2 in one case. All 10 punctures of the collecting system were successfully completed at the first attempt without X-ray exposure. The median time to successful puncture starting from insertion of the needle was 20 s (range . No complications occurred. Conclusions: We describe the first clinical application of a novel navigation system using real-time electromagnetic sensors for percutaneous kidney access. This new technology overcomes the intrinsic limitations of traditional methods of kidney access, allowing safe, precise, fast, and effective puncture of the renal collecting system. Patient summary: We describe a new technology allowing safe and easy puncture of the kidney without radiation exposure. This could significantly facilitate one of the most challenging steps in percutaneous removal of kidney stones.

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“…Inclusion criteria for patient selection were: age older than 18 yr; stone in the renal pelvis; stone size 2.5 cm; and Guy's stone score of 1-2 [12]. …”

Section: Patient Selection Criteriamentioning

confidence: 99%

Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)

et al. 2017

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“…Nephrolithometry scoring systems are based on pre-operative stone and patient features and they demonstrate and stratify relationships between kidney's anatomy and stones. Currently there are three scoring systems; Guy's score [32] described in 2011, S.T.O.N.E. nephrolithometry system [33] and CROES nephrolithometry nomogram [34] in 2013.…”

Section: Ct Beyond the Diagnosis Of Stonementioning

confidence: 99%

Non-contrast CT in the Evaluation of Urinary Tract Stone Obstruction and Haematuria

Ather¹,

Memon²,

Aziz³

et al. 2017

Computed Tomography - Advanced Applications

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Non-contrast computed tomography (CT) abdomen has emerged as a irst line investigation in suspected upper urinary tract obstruction. Underlying causes can usually be ascertained on computed tomography of kidneys, ureters and bladder (CT KUB). However, further investigations may be required to delineate/conirm underlying pathology like ureteropelvic junction obstruction (UPJ), diferentiation between obstruction and residual dilatation. Actual protocol of CT KUB for evaluation of stone disease and haematuria vary on institutional guidelines. CT KUB is not only extremely sensitive and speciic in the diagnosis of stone; it is now used in the pre-operative nomograms in predicting success of various endourological interventions like percutaneous nephrolithotomy (PCNL) and shock wave lithotripsy (SWL). Determination of stone density, stone volume, stone composition, skin to stone distance, presence of ureteral wall oedema, perinephric oedema are highly predictive of stone free rate. CT recognition of various anomalies, presence of retro-renal colon, horse-shoe kidney, malrotation, etc. can help in beter planning to avoid complications. One of the major limitations of CT is the radiation dose, besides cost and availability. Modiication in technique and technological innovation has resulted in signiicant dose reduction from 4.5 to about 1 mSv.

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“…P ercutaneous nephrolithotripsy (PNL) is one of the main methods to treat renal lithiasis, particularly stones with more than 2cm diameter 1 . Although total fragmentation is expected, it is not always possible, and additional procedures are necessary, in special in staghorn or multiple calix stones 2 .…”

Section: Introductionmentioning

confidence: 99%

Can renal stone size and the use of the nephrolithometric system increase the efficacy of predicting the risk of failure of percutaneous nephrolithotripsy?

E¹,

Diniz²,

Souza³

et al. 2017

Rev. Col. Bras. Cir.

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Objective : to verify the association of success rate of percutaneous lithotripsy, Guy score and size of the stone. Methods: one hundred patients submitted to percutaneous nephrolithotripsy were evaluated. All stones were classified according to Guy Score. Patient free of stone was considered when residual fragments were ≤2mm. Results: according to guy Score, 54% were score 1 (Group 1), 18% score 2 (Group 2), 15% score 3 (Group 3), and 13% score 4 (Group 4). Success was observed in 77.77% in Group 1, 27.77% in group 2, 26.6% in Group 3, and 7.69% in Group 4. In patients with Guy score 1, there was statistical significance of prediction of free stone rate when evaluated according to the size of the stone. Among groups 2, 3 and 4 there was no statistical significance, but it was observed a trend in relation to stone size, the bigger the higher the chance of residual fragments. Conclusion: nephrolithometry by Guy Score and size of the stone are single predictors of success of percutaneous nephrolithotripsy. Stone size may influence success rate of patients with Guy Score 1.

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The Guy's Stone Score—Grading the Complexity of Percutaneous Nephrolithotomy Procedures

Cited by 354 publications

References 26 publications

Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)

Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)

Non-contrast CT in the Evaluation of Urinary Tract Stone Obstruction and Haematuria

Can renal stone size and the use of the nephrolithometric system increase the efficacy of predicting the risk of failure of percutaneous nephrolithotripsy?

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