Perkütan Nefrolitotomi’de Skorlama Sistemlerinin Cerrahi Başarıyı Öngörmedeki Yeri: Tek Merkez Sonuçları

Year 2023, Volume: 15 Issue: 3, 94 - 101, 30.09.2023

Emre Şam Ekrem Güner

https://doi.org/10.54233/endouroloji.20231503-1345152

Abstract

Amaç: Biz bu çalışmada, perkütan nefrolitotomide (PNL) en yaygın kullanılan modeller olan Guy’s skoru,
S.T.O.N.E skoru ve CROES nomogramının taşsızlığı öngörme etkinliklerini ve hangi modelin taşsızlığı daha
başarılı öngördüğünü belirlemeyi amaçladık.
Gereç ve Yöntemler: Tersiyer akademik merkezimizde, 2009 ile 2018 tarihleri arasında böbrek taşı
nedeniyle PNL uygulanan 18 yaşından büyük hastaların verileri retrospektif olarak değerlendirildi.
İncelenen parametreler, hastaların demografik verileri, taşa ait özellikler, Guy’s skoru, S.T.O.N.E. skoru, CROES
nomogramı, operasyon süresi, transfüzyon oranı, hastanede kalış süresi ve taşsızlık idi. Taşsızlık açısından
kestirim değerleri receiver operating characteristic (ROC) curve analizi kullanılarak belirlendi.
Bulgular: Çalışmaya toplam 200 hasta dahil edildi. Hastaların yaş ortalaması 43,7 ± 14,6 yıl idi. Hastaların
ortalama taş skorları sırası ile şöyle idi: Guy’s skoru: 2,11 ± 1,01, S,T,O,N,E skoru: 7,54 ± 1,73, CROES nomogramı:
194 ± 62,7, Taşsızlık oranı %66 olarak belirlendi. Taşsızlık sağlanamayan hastalarda taşsızlık sağlananlara göre
Guy’s skoru ve S.T.O.N.E skorunun anlamlı yüksek, CROES nomogramının ise anlamlı düşük olduğu belirlendi
(sırasıyla p<0,001, p<0,001 ve p<0.001). Kestirim değeri ve eğri altındaki alan (AUC) sırasıyla Guy’s skoru için
2,5 ve 0,770, S.T.O.N.E skoru için 7,5 ve 0,722 ve CROES nomogramı için 185 ve 0,843 idi.
Sonuç: PNL’de taşsızlığı öngörmede Guy’s skoru, S.T.O.N.E skoru ile CROES nomogramı etkili modellerdir.

Keywords

CROES nomogramı, Guy’s skoru, perkütan nefrolitotomi, S.T.O.N.E skoru, taşsızlık

Ethical Statement

Bakirkoy Dr. Sadi Konuk Education and Research Hospital Clinical Trials Ethics Committee Date Protocol: 02.09.2019/2019-17-22.

The Role of Scoring Systems in Predicting Surgical Success in Percutaneous Nephrolithotomy: Results from a Single Center

Abstract

Objective: In this study, we aimed to determine the effectiveness of Guy’s score, S.T.O.N.E score, and CROES
nomogram, the most widely used models in percutaneous nephrolithotomy (PNL) for predicting stone-free
status, and to determine which model predicts stone-free status more successfully.
Materials and Methods: The data of patients older than 18 years of age who underwent PNL for kidney
stones at our tertiary academic center between 2009 and 2018 were retrospectively analyzed. Examined
parameters included the demographic data of patients, stone characteristics, Guy’s score, S.T.O.N.E. score,
CROES nomogram, surgical duration, transfusion rate, length of stay, and stone-free status. Prediction
values for stone-free status were determined using receiver operating characteristic (ROC) curve analysis.
Results: A total of 200 patients were included in the study. The mean age of the patients was 43.7 ± 14.6
years. The mean stone scores of the patients were as follows: Guy’s score: 2.11 ± 1.01; S.T.O.N.E. score: 7.54
± 1.73; and CROES nomogram: 194 ± 62.7. The stone-free rate was determined to be 66%. The Guy’s and
S.T.O.N.E. scores were significantly higher, and the CROES nomogram was significantly lower in non-stonefree
patients compared to stone-free patients (p<0.001, p<0.001, and p<0.001, respectively). The cut-off
value and area under curve (AUC) were 2.5 and 0.770 for Guy’s score, 7.5 and 0.722 for S.T.O.N.E score, and
185 and 0.843 for CROES nomogram, respectively.
Conclusion: Guy’s score, S.T.O.N.E score, and CROES nomogram are effective models in predicting stonefree
status in PNL.

Keywords

CROES nomogram, Guy’s score, percutaneous nephrolithotomy, S.T.O.N.E score, stone-free

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