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Perri D, Mazzoleni F, Besana U, Pacchetti A, Morini E, Calandriello M, Pastore AL, Romero-Otero J, Bruyere F, Sighinolfi MC, Rocco B, Micali S, Gozen AS, Liatsikos E, Roche JB, Bozzini G. A proposed mathematical model to help preoperative planning between RIRS and MiniPerc for renal stones between 10 and 20 mm using holmium:Yag laser (Cyber Ho): the stone management according to size-hardness (SMASH) score. Urolithiasis 2024; 52:58. [PMID: 38565776 DOI: 10.1007/s00240-024-01536-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/22/2024] [Indexed: 04/04/2024]
Abstract
To evaluate the performance of a mathematical model to drive preoperative planning between RIRS and MiniPerc (MP) for the treatment of renal stones between 10 and 20 mm. Patients with a renal stone between 10 and 20 mm were enrolled. A mathematical model named Stone Management According to Size-Hardness (SMASH) score was calculated: hounsfield units (HU) χ stone maximum size (cm)/100. Patients were divided into 4 groups: RIRS with score < 15 (Group A), RIRS with score ≥ 15 (Group B), MP with score < 15 (Group C), MP with score ≥ 15 (Group D). Cyber Ho device was always used. Stone free rate (SFR) was assessed after 3 months. Complication rate and need for auxiliary procedures were evaluated. Between January 2019 and December 2021, 350 patients were enrolled (87, 88, 82 and 93 in Groups A, B, C and D). Mean stone size was 13.1 vs 13.3 mm in Group A vs B (p = 0.18) and 16.2 vs 18.1 mm in Group C vs D (p = 0.12). SFR was 82%, 61%, 75% and 85% for Groups A, B, C and D. SFR was comparable between Groups C and D (p = 0.32) and Groups A and C (p = 0.22). SFR was significantly higher in Group A over B (p = 0.03) and in Group D over B (p = 0.02). Complication rate was 2.2%, 3.4%, 12.1%, 12.9% for Groups A, B, C, D. RIRS and MP are both safe and effective. The mathematical model with the proposed cut-off allowed a proper allocation of patients between endoscopic and percutaneous approaches.Registration number of the study ISRCTN55546280.
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Affiliation(s)
- D Perri
- Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy.
- Department of Urology, Sant'Anna Hospital, Via Ravona 20, 22042, San Fermo della Battaglia, Italy.
| | - F Mazzoleni
- Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy
| | - U Besana
- Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy
| | - A Pacchetti
- Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy
| | - E Morini
- Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy
| | - M Calandriello
- Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy
| | - A L Pastore
- Department of Urology, Sapienza University, Rome, Italy
| | - J Romero-Otero
- Department of Urology, Hospital Universitario, 12 De Octubre, Madrid, Spain
| | - F Bruyere
- Department of Urology, Bretonneau Hospital, Tours, France
| | | | - B Rocco
- Department of Urology, Ospedale San Paolo, Milan, Italy
| | - S Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - A S Gozen
- Department of Urology, SLK-Kliniken Heilbronn, Heilbronn, Germany
| | - E Liatsikos
- Department of Urology, University of Patras, Patras, Greece
| | - J B Roche
- Department of Urology, University of Bordeaux, Bordeaux, France
| | - G Bozzini
- Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy
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Illahi Bux K, Rizwan Ahmed R, Farooq F, Daggula NR, Mahmood J, Wasim U, Kumari S, Jan M, Khan F, Kumari U. Clinical Utility of S.T.O.N.E, Guy's Scoring System, and Renal Stone Complexity Scoring in Predicting Outcome of Single-Tract Percutaneous Nephrolithotomy. Cureus 2023; 15:e50983. [PMID: 38259369 PMCID: PMC10801671 DOI: 10.7759/cureus.50983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Several imaging-based scores have been developed to predict postoperative stone-free state (SFS) and complications. This study aimed to assess the accuracy of the S.T.O.N.E., Guy Scoring System (GSS), and Seoul National University Renal Stone Complexity (S-ReSCS) scores in predicting the outcomes of single-tract percutaneous nephrolithotomy (ST-PCNL). This scoring system holds paramount importance for low-income and low-middle-income countries (LMICs), as it is inexpensive and cost-effective for the healthcare system. METHODOLOGY This retrospective study was carried out with 147 participants. Based on the preoperative computerized tomographic (CT) scan, each patient's S.T.O.N.E. score, GSS, and S-ReSCS were recorded. The modified Clavien grading system was used to document intra- and postoperative complications. RESULTS The mean age of the sample population was 45 years. SFS was achieved in 110 (74.8%) patients. The number of calyces involved (p = 0.008), S.T.O.N.E. scoring (p = 0.001), GSS (p = 0.008), and S-ReSCS (0.001) correlated well with the SFS. Forty-nine (33.33%) patients developed complications. The most common complications fell within Clavien grade II. No statistical significance was noted between the S.T.O.N.E. score, GSS, and S-ReSCS with the modified Clavien grading system. CONCLUSION The S.T.O.N.E. scoring, GSS, and S-ReSCS have a high predictive value for achieving SFS in ST-PCNL. In addition, findings from LMICs are comparable with those from the rest of the world.
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Affiliation(s)
- Kausar Illahi Bux
- Radiology, The Kidney Center, Karachi, PAK
- Radiology, Jinnah Postgraduate Medical Center, Karachi, PAK
| | | | - Faryal Farooq
- Diagnostic Radiology, Jinnah Post Graduate Medical Centre, Karachi, PAK
| | | | - Jawad Mahmood
- Gastroenterology and Hepatology, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | | | - Sajana Kumari
- Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Muneeb Jan
- Internal Medicine Department, Khyber Teaching Hospital, Peshawar, PAK
- Medicine, Rehman Medical Institute, Peshawar, PAK
- Cardiology, Lady Reading Hospital, Peshawar, PAK
| | | | - Usha Kumari
- Medicine, Dow University of Health Sciences, Karachi, PAK
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