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Inicio Actas Urológicas Españolas (English Edition) Does success in percutaneous nephrolithotomy depend only on stone size? Analysis...
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Vol. 48. Issue 8.
Pages 603-610 (October 2024)
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Vol. 48. Issue 8.
Pages 603-610 (October 2024)
Original article
Does success in percutaneous nephrolithotomy depend only on stone size? Analysis of the predictive capacity for success and complications of the current nephrolithometry scoring systems and their relationship with the stone surface
¿Depende el éxito en nefrolitotomía percutánea solo del tamaño litiásico? Análisis de la capacidad predictiva de éxito y complicaciones de los actuales sistemas de puntuación de nefrolitometría y su relación con la superficie litiásica
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C. Fernández Baltara,
Corresponding author
, F. Gude Sampedrob, D. Pérez Fentesc
a Complejo Hospitalario Universitario de Pontevedra, Servicio de Urología, Pontevedra, Spain
b Complejo Universitario de Santiago de Compostela, Unidad de Epidemiología, Santiago de Compostela, Spain
c Complejo Universitario de Santiago de Compostela, Servicio de Urología, Santiago de Compostela, Spain
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Tables (3)
Table 1. Epidemiological, clinical and surgical characteristics regarding the success of the intervention in the patients of the series.
Table 2. Results (success and complications) of our series according to their GSS, STONE, CROES and S-ReSC category.
Table 3. Published predictive capacity of the different nephrolithometry scales expressed in area under curve (AUC).
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Abstract
Objective

To analyze the predictive capacity of the nephrolithometry scoring systems (GSS, STONE, CROES and S-ReSC) and stone surface regarding success and complications following percutaneous nephrolithotomy (PCNL).

Methods

We studied 392 patients who had undergone PCNL in our center. Only patients with a non-contrast CT (n = 240) were finally included for analysis. The predictive capacities for success and complications of the different scoring systems were evaluated using ROC curves and their area under the curve (AUC).

Results

Regarding success, the S-ReSC system had the highest predictive capacity with an AUC of 0.681 (95% CI 0.610−0.751), followed by the CROES with 0.667 (95% CI 0.595−0.738), the STONE with 0.654 (95% CI 0.579−0.728) and finally the GSS with 0.626 (95% CI 0.555−0.698). The stone surface as a single variable had an AUC of 0.641 (95% CI 0.565−0.718). As for complications, the S-ReSC had the highest AUC with 0.664 (95% CI 0.57−0.758), followed by STONE with 0.663 (95% CI 0.572−0.755), GSS with 0.626 (95% CI 0.555).−0.698) and CROES with 0.614 (95% CI 0.518−0.7). The stone surface alone had an AUC of 0.616 (95% CI 0.522−0.715).

Conclusion

The nephrolithometry scales analyzed show a moderate predictive capacity for success and complications in patients undergoing PCNL in our center. Moreover, stone surface as an independent variable demonstrates moderate predictive capacity for both outcomes.

Keywords:
Urolithiasis
Percutaneous nephrolithotomy
Nephrolithometry
Scoring systems
Success
Complications
Resumen
Objetivo

Analizar la capacidad predictiva de los sistemas de puntuación de nefrolitometría (Guy’s Stone Score [GSS], Stone size, Tract length, Obstruction, Number of calyces, Essence [STONE], Clinical Research Office of the Endourological Society [CROES] y Seoul National University Renal Complexity Scoring System for Prediction of Stone-Free Rate after PCNL [S-ReSC])y la superficie litiásica en cuanto a éxito y complicaciones en nefrolitotomía percutánea (NLP).

Métodos

Estudio de 392 pacientes sometidos a NLP en nuestro centro. Solo se incluyeron para el análisis los pacientes con una tomografía computarizada (TC) sin contraste (n = 240). Las capacidades predictivas de éxito y complicaciones de los diferentes sistemas de puntuación se evaluaron mediante curvas operativas del receptor (ROC) y su área bajo la curva (ABC).

Resultados

En cuanto al éxito, el sistema S-ReSC tuvo la mayor capacidad predictiva con un ABC de 0,681 (IC 95% 0,610–0,751), seguido del CROES con 0,667 (IC 95% 0,595–0,738), el STONE con 0,654 (95 % IC 0,579–0,728) y finalmente el GSS con 0,626 (IC 95% 0,555–0,698). La superficie litiásica como única variable tuvo un ABC de 0,641 (IC del 95%: 0,565–0,718). En cuanto a las complicaciones, el S-ReSC tuvo el ABC más alto con 0,664 (IC 95% 0,57–0,758), seguido de STONE con 0,663 (IC 95% 0,572–0,755), GSS con 0,626 (IC 95% 0,555).–0,698) y CROES con 0,614 (IC 95% 0,518–0,7). La superficie litiásica como variable independiente tuvo un ABC de 0,616 (IC del 95%: 0,522–0,715).

Conclusión

Las escalas de nefrolitometría analizadas muestran una moderada capacidad predictiva de éxito y complicaciones en pacientes sometidos a NLP en nuestro centro. Además, la superficie litiásica como variable independiente demuestra una capacidad predictiva moderada para ambos resultados.

Palabras clave:
Urolitiasis
Nefrolitotomía percutánea
Nefrolitometría
Éxito
Complicaciones
Superficie

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