Bozkurt Ibrahim Halil, Aydogdu Ozgu, Yonguc Tarik, Yarimoglu Serkan, Sen Volkan, Gunlusoy Bulent, Degirmenci Tansu
Department of Urology, Izmir Bozyaka Training and Research Hospital , Izmir, Turkey .
J Endourol. 2015 Sep;29(9):1006-10. doi: 10.1089/end.2015.0199. Epub 2015 Jul 8.
To compare the Guy and Clinical Research Office of the Endourological Society (CROES) scoring systems in predicting postpercutaneous nephrolithotomy (PCNL) stone-free rate and complications.
A total of 437 patients who underwent PCNL for renal stones were included in the recent retrospective study. All stones were evaluated with CT preoperatively. Mean stone diameter was 701.52±510.65 mm(2). Guy and CROES nephrolithometry scores were calculated for each patient, and their correlation with stone-free status, operative and fluoroscopy time, and length of hospital stay was evaluated. Post-PCNL stone status was evaluated with plain radiography of the kidneys, ureters, and bladder. Postoperative complications were graded according to the modified Clavien classification, and the correlation of both scoring systems with postoperative complications was also investigated.
The mean Guy grade was 2.28±1.12, and the mean CROES score was 196.92±65.89. The overall stone-free rate was 75.1%. There was a significant correlation between the Guy stone score (GSS) and CROES score and stone-free status (P<0.001, P<0.001). Also, both scoring systems were correlated with operative time (P<0.001, P<0.001) and length of hospital stay (P=0.002, P=0.01). The overall complication rate was 34.6%, with most being modified Clavien grade I and grade II. Both scoring systems were significantly correlated with complication rates. Regression analysis showed that both scoring systems were significantly associated with stone-free rates, estimated blood loss (EBL) (>250 mL), and operative time.
Both GSS and CROES nomograms had comparable accuracies in predicting post-PCNL stone-free status. Different from the previous reports, our results showed that both nomograms were predictive of overall complications, EBL, and operative time.
比较盖伊评分系统和腔内泌尿外科协会临床研究办公室（CROES）评分系统在预测经皮肾镜取石术（PCNL）后结石清除率及并发症方面的效果。
本项近期的回顾性研究纳入了437例行PCNL治疗肾结石的患者。术前均对所有结石进行CT评估。结石平均直径为701.52±510.65 mm²。计算每位患者的盖伊评分和CROES肾测量评分，并评估其与结石清除状态、手术时间、透视时间及住院时间的相关性。PCNL术后结石状态通过肾脏、输尿管和膀胱的X线平片进行评估。术后并发症根据改良Clavien分类法进行分级，同时研究两种评分系统与术后并发症的相关性。
盖伊评分的平均值为2.28±1.12，CROES评分的平均值为196.92±65.89。总体结石清除率为75.1%。盖伊结石评分（GSS）与CROES评分和结石清除状态之间存在显著相关性（P<0.001，P<0.001）。此外，两种评分系统均与手术时间（P<0.001，P<0.001）和住院时间（P=0.002，P=0.01）相关。总体并发症发生率为34.6%，多数为改良Clavien I级和II级。两种评分系统均与并发症发生率显著相关。回归分析表明，两种评分系统均与结石清除率、估计失血量（EBL）（>250 mL）和手术时间显著相关。
GSS和CROES列线图在预测PCNL术后结石清除状态方面具有相当的准确性。与既往报道不同的是，我们的结果显示两种列线图均可预测总体并发症、EBL和手术时间。
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