Khan Nasir, Nazim Syed Muhammad, Farhan Muhammad, Salam Basit, Ather Muhammad Hammad
Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan.
Urol Ann. 2020 Oct-Dec;12(4):324-330. doi: 10.4103/UA.UA_136_19. Epub 2020 Aug 10.
The aim of this study was to validate and compare Guy's and S.T.O.N.E. scoring systems in predicting perioperative and postoperative outcome following percutaneous nephrolithotomy (PCNL).
From November 2015 to June 2017, 190 patients with renal stones who underwent single tract unilateral PCNL in the prone position were included in our study. Guy's and S.T.O.N.E. nephrolithometry scores were calculated in each case based on preoperative computed tomography images. The association of these scoring systems with stone-free status, length of hospital stay, operative time, and postoperative complications was studied. Regression analysis was done, and receiver operating characteristic curves were plotted.
Mean S.T.O.N.E. and Guy's stone scores were 8.76 ± 2.29 and 2.70 ± 1.0, respectively. When compared with patients with residual stones, stone-free (SF) patients had significantly lower mean Guy's score (2.58 ± 1.01 vs. 3.23 ± 0.77 [P < 0.001]) and S.T.O.N.E. scores (8.44 ± 2.24 and 10.17 ± 2.0 [P < 0.001]), respectively. On logistic regression analysis, both Guy's score (odds ratio [OR] = 0.48, = 0.001) and S.T.O.N.E score (OR = 0.78, = 0.001) were found to be significantly associated with SF status. Both of these scoring systems were also significantly associated with longer operative time (>90 min), prolonged hospital stay (>3 days) and overall complications. No significant difference was found in the area under curve for both scoring systems for stone clearance.
Both the S.T.O.N.E and Guy's scoring systems were found to predict the outcome of PCNL, either of these could be used in the routine clinical practice for patients' counseling.
本研究旨在验证并比较盖伊（Guy's）评分系统和S.T.O.N.E.评分系统在预测经皮肾镜取石术（PCNL）围手术期和术后结果方面的效果。
2015年11月至2017年6月，190例在俯卧位下行单通道单侧PCNL的肾结石患者纳入本研究。根据术前计算机断层扫描图像计算每例患者的盖伊评分系统和S.T.O.N.E.肾石测量评分。研究这些评分系统与结石清除状态、住院时间、手术时间和术后并发症之间的关联。进行回归分析并绘制受试者工作特征曲线。
S.T.O.N.E.评分系统和盖伊评分系统的结石平均评分分别为8.76±2.29和2.70±1.0。与有残余结石的患者相比，结石清除（SF）患者的盖伊评分系统平均得分（2.58±1.01对3.23±0.77 [P < 0.001]）和S.T.O.N.E.评分系统得分（8.44±2.24和10.17±2.0 [P < 0.001]）显著更低。逻辑回归分析显示，盖伊评分系统（比值比[OR]=0.48，P = 0.001）和S.T.O.N.E.评分系统（OR = 0.78，P = 0.001）均与SF状态显著相关。这两种评分系统还均与较长的手术时间（>90分钟）、延长的住院时间（>3天）和总体并发症显著相关。两种评分系统在结石清除曲线下面积方面未发现显著差异。
发现S.T.O.N.E.评分系统和盖伊评分系统均能预测PCNL的结果，二者均可用于临床常规实践中为患者提供咨询。
