TY - JOUR

T1 - Are we ready to predict percutaneous nephrolithotomy (PCNL) stone-free failure?

AU - Gadzhiev, Nariman

AU - Brovkin, Sergei

AU - Grigoryev, Vladislav

AU - Dmitriev, Vladimir

AU - Baketin, Pyotr

AU - Obidnyak, Vladimir

AU - Pisarev, Aleksei

AU - Shkarupa, Dmitry

AU - Tagirov, Nair

AU - Korol, Valeriy

AU - Petrov, Sergei

N1 - Publisher Copyright: © 2015, © British Association of Urological Surgeons 2015.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective: To develop a tool, both simple and reliable, for postoperative percutaneous nephrolithotomy (PCNL) stone-free failure prediction. Materials and methods: We analysed a sample of 116 patients, who underwent conventional PCNL from 2011 to 2014. Cases with residual stones ⩽ 4 mm in size were regarded as clinically insignificant and ‘stone-free’. Results: According to the low-dose computed tomography (CT) scan performed within 24 hours after operation, the patients were stratified as follows: 72 stone-free and 44 with residual stones. Among the analysed variables, three were derived as most important for prediction purposes: an additional stone in a calyx with an acute angle (⩽ 45°), represented by ‘A’; an additional stone in a long calyx (⩾ 10 mm) with a narrow infundibulum (⩽ 8mm), represented by ‘C’; and a stone size that is > 24 mm, represented by ‘S’. These were abbreviated as the ‘ACS’ score. Depending on the absence or presence of each of these three variables, a score of 0 or 1 was assigned. If the ACS score is 0, then the probability of being a stone-free patient was about 88%; however, when the ACS score is 3, then the probability of being stone free was just 8%. Conclusion: Use of the ACS score seemed to be a simple and reliable tool for PCNL stone-free failure prediction.

AB - Objective: To develop a tool, both simple and reliable, for postoperative percutaneous nephrolithotomy (PCNL) stone-free failure prediction. Materials and methods: We analysed a sample of 116 patients, who underwent conventional PCNL from 2011 to 2014. Cases with residual stones ⩽ 4 mm in size were regarded as clinically insignificant and ‘stone-free’. Results: According to the low-dose computed tomography (CT) scan performed within 24 hours after operation, the patients were stratified as follows: 72 stone-free and 44 with residual stones. Among the analysed variables, three were derived as most important for prediction purposes: an additional stone in a calyx with an acute angle (⩽ 45°), represented by ‘A’; an additional stone in a long calyx (⩾ 10 mm) with a narrow infundibulum (⩽ 8mm), represented by ‘C’; and a stone size that is > 24 mm, represented by ‘S’. These were abbreviated as the ‘ACS’ score. Depending on the absence or presence of each of these three variables, a score of 0 or 1 was assigned. If the ACS score is 0, then the probability of being a stone-free patient was about 88%; however, when the ACS score is 3, then the probability of being stone free was just 8%. Conclusion: Use of the ACS score seemed to be a simple and reliable tool for PCNL stone-free failure prediction.

KW - Computed tomography

KW - kidney

KW - kidney stones

KW - outcome

KW - percutaneous nephrolithotomy

KW - predictive value

KW - quality control

KW - residual stones

KW - scoring system

KW - urolithiasis

UR - http://www.scopus.com/inward/record.url?scp=84951755087&partnerID=8YFLogxK

U2 - 10.1177/2051415815584505

DO - 10.1177/2051415815584505

M3 - Article

AN - SCOPUS:84951755087

VL - 9

SP - 11

EP - 18

JO - Journal of Clinical Urology

JF - Journal of Clinical Urology

SN - 2051-4158

IS - 1

ER -