Department of Urology, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Yıldırım/Bursa, Turkey.
Department of Urology, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Yıldırım/Bursa, Turkey,
Urol Int. 2021;105(1-2):83-89. doi: 10.1159/000510248. Epub 2020 Sep 30.
We aimed to identify factors affecting percutaneous nephrolithotomy (PNL) outcomes among patients with horseshoe kidney (HSK) and assess the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES), Guy's Stone Score (GSS), and S.T.O.N.E. scoring systems.
Data from 98 patients with HSK who underwent PNL between November 2010 and January 2020 were evaluated. Patients were divided into the stone-free (SF) and non-SF groups and compared according to demographic data, stone and surgical characteristics, and stone scoring systems. Multivariate logistic regression analysis was performed to identify factors associated with SF status.
Among the included patients, 87 were male and 11 were female (mean age: 47.37 ± 14.42 years). The SF rate was 84.7% (83 patients). Group analysis identified GSS (p < 0.001), CROES score (p < 0.001), S.T.O.N.E. score (p = 0.014), stone burden (p = 0.045), and multiplicity (p < 0.001) as factors associated with SF status. Among our cohort, 10 patients developed complications. All scoring systems were significantly correlated with SF status (CROES: r = -0.442, p < 0.001; GSS: r = 0.442, p < 0.001; S.T.O.N.E.: r = 0.250, p = 0.013), while CROES score was identified as an independent factor associated with SF status (95% CI: 0.937-0.987; p = 0.003).
PNL is an effective method for treating nephrolithiasis among patients with HSK. Moreover, stone-related factors, such as larger size, multiplicity, and complexity, were associated with procedural failure. Finally, the CROES nomogram was a better predictor of SF status compared with other scoring systems.
本研究旨在确定影响马蹄肾（HSK）患者经皮肾镜取石术（PNL）治疗效果的因素，并评估临床研究办公室的泌尿外科学会（CROES）、Guy 结石评分（GSS）和 S.T.O.N.E. 评分系统的预测准确性。
回顾性分析 2010 年 11 月至 2020 年 1 月期间接受 PNL 治疗的 98 例 HSK 患者的数据。根据患者的人口统计学数据、结石和手术特征以及结石评分系统，将患者分为结石清除（SF）和非 SF 组进行比较。采用多因素逻辑回归分析确定与 SF 状态相关的因素。
本研究共纳入 98 例患者，其中 87 例为男性，11 例为女性（平均年龄：47.37±14.42 岁）。SF 率为 84.7%（83 例）。组间分析发现 GSS（p＜0.001）、CROES 评分（p＜0.001）、S.T.O.N.E. 评分（p=0.014）、结石负荷（p=0.045）和多发性结石（p＜0.001）与 SF 状态相关。本研究中共有 10 例患者发生并发症。所有评分系统与 SF 状态均显著相关（CROES：r=-0.442，p＜0.001；GSS：r=0.442，p＜0.001；S.T.O.N.E.：r=0.250，p=0.013），而 CROES 评分是与 SF 状态相关的独立因素（95%CI：0.937-0.987；p=0.003）。
PNL 是治疗 HSK 患者肾结石的有效方法。此外，结石相关因素，如结石较大、多发性和复杂性，与手术失败有关。最后，CROES 列线图是预测 SF 状态的更好指标，优于其他评分系统。
