Department of Urology, Basaksehir Cam and Sekura State Hospital, Istanbul, Turkey.
Department of Urology, Prof. Dr Cemil Tascioglu City Hospital, Istanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2022 Apr;32(4):372-377. doi: 10.1089/lap.2021.0197. Epub 2021 Jul 19.
Renal stone disease is a common disorder in urology practice. Kidney stone has various treatment methods such as extracorporeal shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy (PCNL). In this study, we aimed to determine the value of S.T.O.N.E. nephrolithometry score, which is considered as a new scoring system for predicting residual stone rate and complications in patients undergoing PCNL due to renal calculi. A total of 120 patients >18 years old who underwent PCNL were evaluated prospectively. Five parameters available from preoperative noncontrast-enhanced computed tomography were measured: stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E) and then S.T.O.N.E. nephrolithometry score was calculated. The prediction of the stone-free rates and complication rates of this scoring was evaluated statistically. When the age, gender, body mass index, comorbidities, and American Society of Anesthesiologists scores of the patients were evaluated according to the patients' postoperative stone-free status, no statistical difference was found between the groups. Patients had a stone-free rate of 78%. Patients' mean neuropilitometry score was calculated to be 7.75 S.T.O.N.E. nephrolithometry score statistically significant ( = .001) for prediction of stone-free status. S.T.O.N.E. nephrolithometry score was significantly correlated with operation time, estimated blood loss, duration of fluoroscopy, duration of hospital stay, and number of punctures. Complications were seen in 13 patients. S.T.O.N.E. nephrolithometry score can be used as an objective criterion for predicting the complexity of the PCNL process. In addition, this scoring system is expected to provide more objective preoperative counseling and can provide standardization in academic studies.
肾结石病是泌尿外科常见疾病。肾结石的治疗方法有很多，如体外冲击波碎石术、逆行肾内手术和经皮肾镜取石术（PCNL）。在这项研究中，我们旨在确定 S.T.O.N.E. 肾结石测量评分的价值，该评分被认为是预测因肾结石行 PCNL 患者残余结石率和并发症的新评分系统。
我们前瞻性评估了 120 名年龄>18 岁的接受 PCNL 的患者。从术前非增强 CT 中测量了 5 个参数：结石大小（S）、通道长度（T）、梗阻（O）、受累肾盂数（N）和实质或结石密度（E），然后计算 S.T.O.N.E. 肾结石测量评分。统计评估了该评分对无结石率和并发症率的预测。
当根据患者术后无结石状态评估患者的年龄、性别、体重指数、合并症和美国麻醉医师协会评分时，组间无统计学差异。患者无结石率为 78%。患者的平均肾结石测量评分计算为 7.75 S.T.O.N.E. 肾结石测量评分对预测无结石状态具有统计学意义（ = .001）。S.T.O.N.E. 肾结石测量评分与手术时间、估计出血量、透视时间、住院时间和穿刺次数显著相关。13 例患者出现并发症。
S.T.O.N.E. 肾结石测量评分可作为预测 PCNL 过程复杂性的客观标准。此外，该评分系统有望提供更客观的术前咨询，并为学术研究提供标准化。
