预测经皮肾镜取石术结果评分系统的外部验证与比较：单中心506例经验
External Validation and Comparisons of the Scoring Systems for Predicting Percutaneous Nephrolithotomy Outcomes: A Single Center Experience with 506 Cases.
作者信息
Yarimoglu Serkan, Bozkurt Ibrahim Halil, Aydogdu Ozgu, Yonguc Tarik, Gunlusoy Bulent, Degirmenci Tansu
机构信息
1 Department of Urology, Igdir Central Hospital , Igdir, Turkey .
2 Department of Urology, Bozyaka Training and Research Hospital , Izmir, Turkey .
出版信息
J Laparoendosc Adv Surg Tech A. 2017 Dec;27(12):1284-1289. doi: 10.1089/lap.2017.0355. Epub 2017 Sep 5.
BACKGROUND
To validate and compare the stone scoring systems (stone size [S], tract length [T], obstruction [O], number of involved calices [N], and essence or stone density [E] [S.T.O.N.E.], Guy's Stone Score [GSS], Clinical Research Office of the Endourological Society [CROES], and Seoul National University Renal Stone Complexity [S-ReSC]) used to predict postoperative stone-free status and complications after percutaneous nephrolithotomy (PCNL).
METHODS
A total of 567 patients who underwent PCNL for renal stones between January 2012 and August 2015 were included in the recent retrospective study. Sixty-one patients who had not done preoperative CT were excluded from the study. GSS, S.T.O.N.E., S-ReSC, and CROES nephrolithometry scores were calculated for each patient, and their potential association with stone-free status, operative and fluoroscopy time, and length of stay (LOS) was evaluated. Postoperative complications were graded according to the modified Clavien classification, and the correlation of scoring systems with postoperative complications was also investigated.
RESULTS
The mean CROES, S.T.O.N.E., GSS, and S-ReSC scores were 203.7 ± 59.8, 7.52 ± 1.8, 2.08 ± 0.9, and 3.35 ± 2.2, respectively. The overall stone-free rate was 77.9%. All scoring systems were significantly correlated with stone-free status and operation time. While GSS, S.T.O.N.E., and CROES systems were significantly correlated with complication rates (CR), S-ReSC score failed to predict CR. All scoring systems except S.T.O.N.E. were significantly correlated with LOS. CROES and S-ReSC scores were predictive of estimated blood loss (EBL), while GSS and S.T.O.N.E. failed to predict EBL.
CONCLUSIONS
Recent study demonstrated that S.T.O.N.E., GSS, CROES, and S-ReSC scoring systems could effectively predict postoperative stone-free status. Although S-ReSC scoring system failed to predict CR, the rest three scoring systems were significantly correlated with postoperative CR.
背景
验证并比较用于预测经皮肾镜取石术（PCNL）术后结石清除状态及并发症的结石评分系统（结石大小[S]、通道长度[T]、梗阻情况[O]、受累肾盏数量[N]以及结石成分或密度[E][S.T.O.N.E.]、盖伊结石评分[GSS]、腔内泌尿外科协会临床研究办公室[CROES]和首尔国立大学肾结石复杂性评分[S - ReSC]）。
方法
在这项近期的回顾性研究中，纳入了2012年1月至2015年8月期间因肾结石接受PCNL的567例患者。61例未进行术前CT检查的患者被排除在研究之外。计算每位患者的GSS、S.T.O.N.E.、S - ReSC和CROES肾结石测量评分，并评估它们与结石清除状态、手术及透视时间和住院时间（LOS）之间的潜在关联。术后并发症根据改良的Clavien分类进行分级，并研究评分系统与术后并发症的相关性。
结果
CROES、S.T.O.N.E.、GSS和S - ReSC评分的平均值分别为203.7±59.8、7.52±1.8、2.08±0.9和3.35±2.2。总体结石清除率为77.9%。所有评分系统均与结石清除状态和手术时间显著相关。虽然GSS、S.T.O.N.E.和CROES系统与并发症发生率（CR）显著相关，但S - ReSC评分未能预测CR。除S.T.O.N.E.外，所有评分系统均与LOS显著相关。CROES和S - ReSC评分可预测估计失血量（EBL），而GSS和S.T.O.N.E.未能预测EBL。
结论
近期研究表明，S.T.O.N.E.、GSS、CROES和S - ReSC评分系统可有效预测术后结石清除状态。虽然S - ReSC评分系统未能预测CR，但其余三个评分系统与术后CR显著相关。
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