Uruc Fatih, Yuksel Ozgur Haki, Urkmez Ahmet, Sahin Aytac, Aras Bekir, Verit Ayhan
Department of Urology. Fatih Sultan Mehmet Research & Training Hospital. Istanbul. Turkey.
Department of Urology. Dumlupinar University Faculty of Medicine. Kutahya. Turkey.
Arch Esp Urol. 2015 Nov;68(9):710-7.
In this study, our aim was to determine the role of Guy's stone scoring system (GSS) in the prediction of percutaneous nephrolithotomy (PNL) success and its ability to foresee potential complications in consideration of Clavien grading system (CGS).
The data of 244 patients who underwent PNL between January 2009 and May 2014 were retrospectively examined. Renal stones were evaluated using GSS with the aid of the patients' preoperative radiological evaluations and their postoperative complications were assessed with CGS.
Mean age of the patients (men, n=166; 68% and women, n=78; 32%) was 46.50±13.12 years (range, 16-80 yrs). Clinically significant residual stones were not detected in 195 (79.9%) patients, while they were found in 49 (20.1%) patients. Guy's stone scores of 1, 2, 3 and 4 points were estimated in 21.3, 37.7, 29.9, and 11.1% of the cases, respectively. Based on modified Clavien complication grading system, complications were categorized as Clavien grade 1, 2 and 3 in 81.9, 17.2, and 0.8% of the cases, respectively. Clavien Grade 4 and 5 complications were not encountered. A statistically significant correlation was found between Guy's Stone scores and Clavien grades (p<0.02). A statistically and highly significant difference was detected between Guy's stone scores of the cases with respect to residual stones (p=0.001; p<0.01).
Our study findings have revealed that GSS is a successful and easily applicable method for the prediction of success and likelihood of complications of PNL.
在本研究中，我们的目的是确定盖氏结石评分系统（GSS）在预测经皮肾镜取石术（PNL）成功率方面的作用，以及在考虑Clavien分级系统（CGS）的情况下其预见潜在并发症的能力。
回顾性分析2009年1月至2014年5月期间接受PNL的244例患者的数据。借助患者术前影像学评估，使用GSS对肾结石进行评估，并使用CGS评估其术后并发症。
患者的平均年龄为46.50±13.12岁（范围为16 - 80岁），其中男性166例（68%），女性78例（32%）。195例（79.9%）患者未检测到具有临床意义的残留结石，49例（20.1%）患者检测到残留结石。盖氏结石评分为1、2、3和4分的病例分别占21.3%、37.7%、29.9%和11.1%。根据改良的Clavien并发症分级系统，并发症分别在81.9%、17.2%和0.8%的病例中被分类为Clavien 1级、2级和3级。未遇到Clavien 4级和5级并发症。盖氏结石评分与Clavien分级之间存在统计学显著相关性（p<0.02）。在有残留结石的病例中，盖氏结石评分之间存在统计学和高度显著差异（p = 0.001；p<0.01）。
我们的研究结果表明，GSS是一种成功且易于应用的方法，可用于预测PNL的成功率和并发症发生的可能性。
