Sinha Rajan Kumar, Mukherjee Subhabrata, Jindal Tarun, Sharma Pramod Kumar, Saha Barun, Mitra Nilanjan, Kumar Jay, Mukhopadhyay Chandranath, Ghosh Nabankur, Kamal Mir Reza, Mandal Soumendra Nath, Karmakar Dilip
Department of Urology, Calcutta National Medical College, Kolkata, 700014, India,
Urolithiasis. 2015 Aug;43(4):349-53. doi: 10.1007/s00240-015-0769-1. Epub 2015 Apr 8.
To prospectively evaluate the ability of Guy's Stone Score (GSS) in predicting stone clearance rate and complication rate (by modified Clavien grade) for renal stones treated by percutaneous nephrolithotomy (PNL). From January 2013 to June 2014, a total of 142 patients undergoing PNL were evaluated prospectively. Patients with co-morbidities like hypertension, diabetes, renal failure were excluded from the study. All patients were classified according to GSS based on the findings of pre-operative intravenous urography (IVU) and per-operative retrograde pyelography (RGP). All PNL procedures were done by standard technique in prone position and success was defined as no residual stone visible on X-ray KUB done on the third postoperative day. Complications were classified according to modified Clavien grading system. The initial stone clearance rate was 71.1% and overall final stone clearance rate was 90.14%. The complication rate according to Clavien grading system was 40.1%. The final stone clearance rates were 93.9, 85.71, 90.47, and 77.77% in GSS I, II, III, and IV, respectively (p<0.001, <0.05, <0.05 and >0.05, respectively). The Clavien complication rates were 23, 61, 52, and 77.7% in GSS I, II, III, and IV, respectively (p<0.001). The GSS is a simple and easily reproducible system to preoperatively predict stone-free rate and perioperative complication rate. It helps in better patient counseling preoperatively.
前瞻性评估盖氏结石评分（GSS）预测经皮肾镜取石术（PNL）治疗肾结石的结石清除率和并发症发生率（采用改良Clavien分级）的能力。2013年1月至2014年6月，对142例行PNL的患者进行了前瞻性评估。患有高血压、糖尿病、肾衰竭等合并症的患者被排除在研究之外。根据术前静脉肾盂造影（IVU）和术中逆行肾盂造影（RGP）的结果，所有患者均按照GSS进行分类。所有PNL手术均采用标准俯卧位技术进行，成功定义为术后第三天腹部平片（KUB）上无残留结石可见。并发症根据改良Clavien分级系统进行分类。初始结石清除率为71.1%，总体最终结石清除率为90.14%。根据Clavien分级系统的并发症发生率为40.1%。GSS I、II、III和IV级的最终结石清除率分别为93.9%、85.71%、90.47%和77.77%（p分别<0.001、<0.05、<0.05和>0.05）。GSS I、II、III和IV级的Clavien并发症发生率分别为23%、61%、52%和77.7%（p<0.001）。GSS是一种简单且易于重复的系统，可术前预测无石率和围手术期并发症发生率。它有助于术前更好地向患者提供咨询。
