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Published in: World Journal of Urology 8/2016

01-08-2016 | Original Article

Percutaneous nephrolithotomy for staghorn stones: Which nomogram can better predict postoperative outcomes?

Authors: Stavros Sfoungaristos, Ofer N. Gofrit, Dov Pode, Ezekiel H. Landau, Mordechai Duvdevani

Published in: World Journal of Urology | Issue 8/2016

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Abstract

Purpose

To identify independent predictors for postoperative stone-free status after percutaneous nephrolithotomy (PCNL) for staghorn stones and to compare Guy’s, CROES and STONE nomograms regarding their predictive ability and accuracy specifically for staghorn stones.

Methods

Data of 286 patients who underwent PCNL in our department were collected and analyzed. Several parameters, including the three nomograms, were analyzed to reveal independent predictors for postoperative stone-free status. The area under the curve was used to assess the predictive ability of the independent predictors.

Results

A total of 73 staghorn calculi were identified with mean stone burden of 1253.5 mm2. Mean Guy’s, CROES and STONE score was 3.34, 125.8 and 9.95, respectively. Postoperative stone-free rate was 65.8 %. In univariate analysis, all three nomograms were significantly associated with stone-free status. However, STONE was the only significant independent predictor in multivariate analysis. STONE also revealed the highest predictive accuracy compared to Guy’s and CROES nomogram.

Conclusions

STONE nephrolithometry was found to be the only predictor for stone-free rate after PCNL for staghorn stones compared to Guy’s and CROES nomograms.
Literature
1.
go back to reference de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A (2011) The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol 25:11–17CrossRefPubMed de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A (2011) The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol 25:11–17CrossRefPubMed
2.
go back to reference Thomas K, Smith NC, Hegarty N, Glass JM (2011) The Guy’s stone score–grading the complexity of percutaneous nephrolithotomy procedures. Urology 78:277–2281CrossRefPubMed Thomas K, Smith NC, Hegarty N, Glass JM (2011) The Guy’s stone score–grading the complexity of percutaneous nephrolithotomy procedures. Urology 78:277–2281CrossRefPubMed
3.
go back to reference Smith A, Averch TD, Shahrour K, Opondo D, Daels FP, Labate G, Turna B, de la Rosette JJ (2013) A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol 190:149–156CrossRefPubMed Smith A, Averch TD, Shahrour K, Opondo D, Daels FP, Labate G, Turna B, de la Rosette JJ (2013) A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol 190:149–156CrossRefPubMed
4.
go back to reference Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, Hillelsohn J, Smith AD, Okeke Z (2013) S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology 81:1154–1159CrossRefPubMed Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, Hillelsohn J, Smith AD, Okeke Z (2013) S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology 81:1154–1159CrossRefPubMed
5.
go back to reference Vicentini FC, Marchini GS, Mazzucchi E, Claro JF, Srougi M (2014) Utility of the Guy’s stone score based on computed tomographic scan findings for predicting percutaneous nephrolithotomy outcomes. Urology 83:1248–1253CrossRefPubMed Vicentini FC, Marchini GS, Mazzucchi E, Claro JF, Srougi M (2014) Utility of the Guy’s stone score based on computed tomographic scan findings for predicting percutaneous nephrolithotomy outcomes. Urology 83:1248–1253CrossRefPubMed
6.
go back to reference Ingimarsson JP, Dagrosa LM, Hyams ES, Pais VM Jr (2014) External validation of a preoperative renal stone grading system: reproducibility and inter-rater concordance of the Guy’s stone score using preoperative computed tomography and rigorous postoperative stone-free criteria. Urology 83:45–49CrossRefPubMed Ingimarsson JP, Dagrosa LM, Hyams ES, Pais VM Jr (2014) External validation of a preoperative renal stone grading system: reproducibility and inter-rater concordance of the Guy’s stone score using preoperative computed tomography and rigorous postoperative stone-free criteria. Urology 83:45–49CrossRefPubMed
7.
go back to reference Akhavein A, Henriksen C, Syed J, Bird VG (2015) Prediction of single procedure success rate using S.T.O.N.E. nephrolithometry surgical classification system with strict criteria for surgical outcome. Urology 85:69–73CrossRefPubMed Akhavein A, Henriksen C, Syed J, Bird VG (2015) Prediction of single procedure success rate using S.T.O.N.E. nephrolithometry surgical classification system with strict criteria for surgical outcome. Urology 85:69–73CrossRefPubMed
8.
go back to reference Sfoungaristos S, Lorber A, Gofrit ON, Yutkin V, Landau EH, Pode D, Duvdevani M (2015) External validation and predictive accuracy assessment of Guy’s stone score as a preoperative tool for estimating percutaneous nephrolithotomy outcomes. J Endourol (Epub ahead of print) Sfoungaristos S, Lorber A, Gofrit ON, Yutkin V, Landau EH, Pode D, Duvdevani M (2015) External validation and predictive accuracy assessment of Guy’s stone score as a preoperative tool for estimating percutaneous nephrolithotomy outcomes. J Endourol (Epub ahead of print)
9.
go back to reference Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr (2005) Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 173:1991–2000CrossRefPubMed Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr (2005) Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 173:1991–2000CrossRefPubMed
10.
go back to reference Desai M, De Lisa A, Turna B, Rioja J, Walfridsson H, D’Addessi A, Wong C, Rosette On Behalf Of The Croes Pcnl Study Group J (2011) The clinical research office of the endourological society percutaneous nephrolithotomy global study: staghorn versus nonstaghorn stones. J Endourol 25:1263–1268CrossRefPubMed Desai M, De Lisa A, Turna B, Rioja J, Walfridsson H, D’Addessi A, Wong C, Rosette On Behalf Of The Croes Pcnl Study Group J (2011) The clinical research office of the endourological society percutaneous nephrolithotomy global study: staghorn versus nonstaghorn stones. J Endourol 25:1263–1268CrossRefPubMed
11.
go back to reference Rocco F, Mandressi A, Larcher P (1984) Surgical classification of renal calculi. Eur Urol 10:121–123PubMed Rocco F, Mandressi A, Larcher P (1984) Surgical classification of renal calculi. Eur Urol 10:121–123PubMed
12.
go back to reference Griffith DP, Valiquette L (1987) PICA/burden: a staging system for upper tract urinary stones. J Urol 138:253–257PubMed Griffith DP, Valiquette L (1987) PICA/burden: a staging system for upper tract urinary stones. J Urol 138:253–257PubMed
13.
go back to reference Rassweiler J, Gumpinger R, Miller K, Hölzermann F, Eisenberger F (1986) Multimodal treatment (extracorporeal shock wave lithotripsy and endourology) of complicated renal stone disease. Eur Urol 12:294–304PubMed Rassweiler J, Gumpinger R, Miller K, Hölzermann F, Eisenberger F (1986) Multimodal treatment (extracorporeal shock wave lithotripsy and endourology) of complicated renal stone disease. Eur Urol 12:294–304PubMed
14.
go back to reference Tiselius HG, Andersson A (2003) Stone burden in an average Swedish population of stone formers requiring active stone removal: How can the stone size be estimated in the clinical routine? Eur Urol 43:275–281CrossRefPubMed Tiselius HG, Andersson A (2003) Stone burden in an average Swedish population of stone formers requiring active stone removal: How can the stone size be estimated in the clinical routine? Eur Urol 43:275–281CrossRefPubMed
15.
go back to reference de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, Wolf JS Jr, Grabe M, Gravas S (2012) Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 62:246–255CrossRefPubMed de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, Wolf JS Jr, Grabe M, Gravas S (2012) Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 62:246–255CrossRefPubMed
16.
go back to reference Noureldin YA, Elkoushy MA, Andonian S (2015) Which is better? Guy’s versus S.T.O.N.E. nephrolithometry scoring systems in predicting stone-free status post-percutaneous nephrolithotomy. World J Urol (Epub ahead of print) Noureldin YA, Elkoushy MA, Andonian S (2015) Which is better? Guy’s versus S.T.O.N.E. nephrolithometry scoring systems in predicting stone-free status post-percutaneous nephrolithotomy. World J Urol (Epub ahead of print)
17.
go back to reference Bozkurt IH, Aydogdu O, Yonguc T, Yarimoglu S, Sen V, Gunlusoy B, Degirmenci T (2015) Comparison of Guy and Clinical Research Office of the Endourological Society nephrolithometry scoring systems for predicting stone-free status and complication rates after percutaneous nephrolithotomy: a single center study with 437 cases. J Endourol (Epub ahead of print) Bozkurt IH, Aydogdu O, Yonguc T, Yarimoglu S, Sen V, Gunlusoy B, Degirmenci T (2015) Comparison of Guy and Clinical Research Office of the Endourological Society nephrolithometry scoring systems for predicting stone-free status and complication rates after percutaneous nephrolithotomy: a single center study with 437 cases. J Endourol (Epub ahead of print)
18.
go back to reference Labadie K, Okhunov Z, Akhavein A, Moreira DM, Moreno-Palacios J, Del Junco M, Okeke Z, Bird V, Smith AD, Landman J (2015) Evaluation and comparison of urolithiasis scoring systems used in percutaneous kidney stone surgery. J Urol 193:154–159CrossRefPubMed Labadie K, Okhunov Z, Akhavein A, Moreira DM, Moreno-Palacios J, Del Junco M, Okeke Z, Bird V, Smith AD, Landman J (2015) Evaluation and comparison of urolithiasis scoring systems used in percutaneous kidney stone surgery. J Urol 193:154–159CrossRefPubMed
19.
go back to reference Opondo D, Gravas S, Joyce A, Pearle M, Matsuda T, Sun YH, Assimos D, Denstedt J, de la Rosette J (2014) Standardization of patient outcomes reporting in percutaneous nephrolithotomy. J Endourol 28:767–774CrossRefPubMed Opondo D, Gravas S, Joyce A, Pearle M, Matsuda T, Sun YH, Assimos D, Denstedt J, de la Rosette J (2014) Standardization of patient outcomes reporting in percutaneous nephrolithotomy. J Endourol 28:767–774CrossRefPubMed
20.
go back to reference Raman JD, Bagrodia A, Gupta A, Bensalah K, Cadeddu JA, Lotan Y, Pearle MS (2009) Natural history of residual fragments following percutaneous nephrostolithotomy. J Urol 181:1163–1168CrossRefPubMed Raman JD, Bagrodia A, Gupta A, Bensalah K, Cadeddu JA, Lotan Y, Pearle MS (2009) Natural history of residual fragments following percutaneous nephrostolithotomy. J Urol 181:1163–1168CrossRefPubMed
21.
go back to reference Skolarikos A, Papatsoris AG (2009) Diagnosis and management of postpercutaneous nephrolithotomy residual stone fragments. J Endourol 23:1751–1755CrossRefPubMed Skolarikos A, Papatsoris AG (2009) Diagnosis and management of postpercutaneous nephrolithotomy residual stone fragments. J Endourol 23:1751–1755CrossRefPubMed
Metadata
Title
Percutaneous nephrolithotomy for staghorn stones: Which nomogram can better predict postoperative outcomes?
Authors
Stavros Sfoungaristos
Ofer N. Gofrit
Dov Pode
Ezekiel H. Landau
Mordechai Duvdevani
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 8/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1743-9

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