MP30-19 IMPACT OF THE GUY'S STONE SCORE ON SUCESS RATES FOR PERCUTANEOUS NEPHROLITHOTOMY

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy III1 Apr 2015MP30-19 IMPACT OF THE GUY'S STONE SCORE ON SUCESS RATES FOR PERCUTANEOUS NEPHROLITHOTOMY Fabio C. Vicentini, Carlos Watanabe-Silva, Thiago A.C. Ferreira, Claudio B. Murta, and Joaquim F.A. Claro Fabio C. VicentiniFabio C. Vicentini More articles by this author , Carlos Watanabe-SilvaCarlos Watanabe-Silva More articles by this author , Thiago A.C. FerreiraThiago A.C. Ferreira More articles by this author , Claudio B. MurtaClaudio B. Murta More articles by this author , and Joaquim F.A. ClaroJoaquim F.A. Claro More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.601AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large kidney stones. The aim of the study was to evaluate which variables impact the success rates of PCNL. METHODS We performed a prospective study of consecutive patients that underwent to PCNL between July 2011 and July 2014. The variables analyzed were gender, age, body mass index (BMI), ASA score, stone diameter, Guy's Stone Score (GSS), number of punctures, calyx puncture site, supracostal access and patient positioning. Complications were graded according to the modified Clavien Classification. Success was considered as fragments ≤4 mm on the first post-operative day (POD1) on CT scan. The tests used in the univariate analyzes were chi-square and Fisher Exact test for categorical measures and Student's t-test for independent samples continuous parameters. For the multivariate analysis, we performed logistic regression. We used a 0.05 significance level. RESULTS A total of 468 patients were included in the study and 517 PCNL were performed. The mean age was 48.3±12.8 years, mean BMI of 27.3±5.0 and 57.8% were female. According to the ASA score, 35.1% were ASA 1, 59.5% were ASA 2 and 5.4% were ASA 3. Regarding patient position, 18% were in prone position, 66.9% in complete supine position, 4.1% in classic Valdivia and 11% in Galdakao position. Most punctures were on lower and middle calyx (65.8% and 24.8%). 9.3% of the punctures were supracostal. Mean surgical time was 114.6±52.78 min. The overall success rate was 55.1%. According to the GSS, the success rate for GSS I was 85.1%, GSS II was 59.4%, GSS III was 40.7% and for GSS IV was 23.3% (p <0.0001). On univariate analysis, the significant variables related to success were supine position (p=0.031), GSS (p<0.0001) and stone diameter (p<0.0001). After the multivariate analysis, it was found that only Guy's Stone Score was statistically significant for success. Odds ratio between GSS groups: OR12 3.55 (CI95% 1.95-6.69), OR23 1.91 (CI95% 1.19-3.08), OR34 1.92 (CI95%0.97-3.89). CONCLUSIONS The Guy's Stone Score was the only predictive factor of success for PCNL. This instrument is easy to use and should be incorporated on stone evaluation and patient counseling. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e354 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fabio C. Vicentini More articles by this author Carlos Watanabe-Silva More articles by this author Thiago A.C. Ferreira More articles by this author Claudio B. Murta More articles by this author Joaquim F.A. Claro More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...