Abdrabuh Abdrabuh Mostafa Ibrahim, Ghanem Maged Mohamad Abdelaziz, Yahia Mahmoud Abdalla Aboelfath, Fawzy Mohamad Nazim
Department of Urology, Al-Azhar University Hospitals, Cairo, Egypt.
Department of Diagnostic Radiology, Al-Azhar University Hospitals, Cairo, Egypt.
Urol Ann. 2021 Jan-Mar;13(1):14-18. doi: 10.4103/UA.UA_158_19. Epub 2021 Jan 19.
The objective was to assess the reliability and validity of "S.T.O.N.E" nephrolithometry scoring system to predict the stone-free rate (SFR) after percutaneous nephrolithotomy (PNL).
A total of 123 patients with unilateral radiopaque stones ≥2 cm were included in the study. According to S.T.O.N.E score, five parameters available from preoperative computed tomography (CT) without contrast were measured: stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence of stone (E). The Stone free rates evaluated within one month postoperatively by plain X-ray and/or CT scan without contrast.
The mean S.T.O.N.E. score in this study was 7.4 in stone-free (SF) group and 9.3 in residual stone group ( = 0.0001). Patients with SF comprised 82.1% after the first PNL, whereas 17.9% had significant residual stones >4 mm. Postoperative complications were 8%. The most common complications were bleeding requiring transfusion. The size of stone ( = 0.002) and number of calices involved ( = 0.001) had a statistically significant difference between patients with residual stones, other components were not. There was a statistically significant difference between non-SF and SF according to the hospital stay ( = 0.002).
This score predicted the clearance after PNL. The size of calculi and number of calices involved statistically affected the stone clearance, whereas other S.T.O.N.E scoring parameters were not. There was a statistically significant difference between SF and residual stones groups according to the hospital stay ( = 0.0001).
评估“S.T.O.N.E”肾结石测量评分系统预测经皮肾镜取石术（PNL）后无结石率（SFR）的可靠性和有效性。
本研究共纳入123例单侧不透X线结石≥2 cm的患者。根据S.T.O.N.E评分，测量术前非增强计算机断层扫描（CT）可得的五个参数：结石大小（S）、通道长度（T）、梗阻情况（O）、受累肾盏数量（N）和结石密度（E）。术后1个月内通过腹部平片和/或非增强CT扫描评估无结石率。
本研究中，无结石（SF）组的平均S.T.O.N.E评分为7.4分，残留结石组为9.3分（P = 0.0001）。首次PNL术后，SF患者占82.1%，而17.9%有>4 mm的明显残留结石。术后并发症发生率为8%。最常见的并发症是需要输血的出血。残留结石患者的结石大小（P = 0.002）和受累肾盏数量（P = 0.001）有统计学显著差异，其他因素无差异。根据住院时间，非SF组和SF组有统计学显著差异（P = 0.002）。
该评分可预测PNL后的结石清除情况。结石大小和受累肾盏数量对结石清除有统计学显著影响，而其他S.T.O.N.E评分参数无影响。根据住院时间，SF组和残留结石组有统计学显著差异（P = 0.0001）。
