Abstract

Renal stone disease has been affecting people for centuries. Percutaneous nephrolithotomy is one of the five interventions offered to a patient with renal stone. With the continuous development of noninvasive or minimally invasive techniques, these surgical procedures have been refined over time. This study was conducted to find the success rate of percutaneous nephrolithotomy in renal stone using Guy's score and complication by Modified Clavien score. This descriptive cross-sectional study was done among 114 patients who underwent percutaneous nephrolithotomy in a tertiary care hospital, from September 2016 to December 2018 after receiving ethical approval from the Institutional Review Committee. Convenient sampling was done. All patients were informed about the potential benefits and risks of the percutaneous nephrolithotomy procedure and patients signed an informed written consent form. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion. Statistical analysis was done by using Statistical Package for Social Sciences version 22.2. Forty-six (40.3%) patients had Guy's stone score I, 43 (37.71%) patients had a score of II, 15 (13.6%) patients had a score of III and 10 (8.77%) patients had a score of IV. The success rates of stone clearance were 97.8 %, 95.3%, 80% and 50% for Guy's stone score 1, 2, 3 and 4 respectively. A total of 114 patients were enrolled in the study out of which 66 were male and 48 were female. Eighteen patients experienced some form of complications out of which 3 patients needed surgical intervention with Modified Clavien score of III. Using Guy's scoring system for percutaneous nephrolithotomy we evaluated the success rate. It is reproducible, easy and proves to be a useful tool to counsel patients about stonefree rate and prognosis for the surgical procedure. Modified Clavien score was helpful in evaluating complication rate.

Highlights

  • Renal stone disease has been affecting people for centuries

  • This descriptive cross-sectional study was done among 114 patients who underwent percutaneous nephrolithotomy in a tertiary care hospital, from September 2016 to December 2018 after receiving ethical approval from the Institutional Review Committee

  • Forty-six (40.3%) patients had Guy’s stone score I, 43 (37.71%) patients had a score of II, 15 (13.6%) patients had a score of III and 10 (8.77%) patients had a score of IV

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Summary

Introduction

Percutaneous nephrolithotomy is one of the five interventions offered to a patient with renal stone. This study was conducted to find the success rate of percutaneous nephrolithotomy in renal stone using Guy’s score and complication by Modified Clavien score. Individuals requiring intervention are offered mainly 1 of 5 interventions: ureteroscopic lithotripsy (URSL), extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), open surgery or retrograde intrarenal surgery (RIRS). Joshi et al Complications and Success Rate of Percutaneous Nephrolithotomy in Renal Stone: A Descriptive Cross-sectional Study. No standardized method is available to predict the stone-free rate after PCNL. Aiming to obtain a quick, simple and reproducible method for the prediction of PCNL outcomes, Thomas et al developed Guy’s scoring system to grade PCNL stone-free rate and complications.[3] Scoring systems help a surgeon in choosing surgical options and bring about better patient outcome

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