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    Comparison of Scoring Systems in Pediatric Mini-Percutaneous Nephrolithotomy
    (Elsevier Science Inc, 2016) Utangac, Mehmet Mazhar; Tepeler, Abdulkadir; Daggulli, Mansur; Tosun, Muhammed; Dede, Onur; Armagan, Abdullah
    OBJECTIVE To apply urolithiasis scoring systems to the pediatric miniperc procedure and to compare their predictive capability for postoperative outcomes. MATERIALS AND METHODS Records from 2 referral centers of patients under 18 years of age who had the miniperc procedure between 2010 and 2015 were retrospectively investigated. All patients included in the study were graded by the same surgeon according to Guy's and Clinical Research Office of the Endourological Society (CROES) scoring systems using preoperative imaging methods. Patient demographics and outcomes were compared according to the complexity of the procedure as graded by each scoring system. RESULTS The mean age of the 97 patients was 7.1 +/- 5.2 (1-17) years. The mean stone burden and number were 388.4 +/- 233.9 mm(2) and 1.5 +/- 1.3, respectively. The mean procedure, fluoroscopy, and hospitalization times were 78.2 +/- 32.8 minutes, 144.8 +/- 84.3 seconds, and 4.1 +/- 2.8 days, respectively. The mean hematocrit drop was calculated as 2.2 +/- 2.2. The mean scores were 1.7 +/- 1.0 and 259.9 +/- 50.6 for Guy's and CROES scoring systems, respectively. In the multivariate analysis, stone-free status was found to be associated with Guy's (r: -0.464, p: .000) and CROES (r: 0.490, : 0.000) scoring systems and stone burden (r: -0.161, p: .041). In the analysis of factors related to complication, Guy's score was identified as an independent predictor of complication (p: .02, odds ratio: 1.9, 95% confidence interval 1.097-3.319). CONCLUSION According to our results, using Guy's and CROES scoring systems, stone-free ratios after percutaneous nephrolithotomy may be predicted preoperatively. In addition, Guy's system is a predictor of postoperative complication rate. (C) 2016 Elsevier Inc.
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    Öğe
    Do the urolithiasis scoring systems predict the success of percutaneous nephrolithotomy in cases with anatomical abnormalities?
    (Springer, 2017) Kocaaslan, Ramazan; Tepeler, Abdulkadir; Buldu, Ibrahim; Tosun, Muhammed; Utangac, Mehmet Mazhar; Karakan, Tolga; Ozyuvali, Ekrem
    The objective of this study is to assess the utility of the Guy, S.T.O.N.E., and CROES nephrolithometry scoring systems (SS), and compare the capability of each system to predict percutaneous nephrolithotomy (PNL) outcome in patients with anatomical abnormalities. We retrospectively collected medical records of patients with anatomical abnormalities who underwent PNL for the treatment of renal calculi by experienced surgical teams in four referral centers. All of the patients were graded by a single observer from each department based on preoperative computed tomography images using each SS. Patient demographics and outcomes were compared according to the complexity of the procedure as graded by each scoring system. A total of 137 cases with anatomical abnormalities [horseshoe kidney (n = 46), malrotation (n = 33), kypho and/or scoliosis (n = 31) and ectopic kidney (n = 27)] were assessed retrospectively. The mean stone burden, number, and density were 708.5 mm(2), 1.7, and 791.8 HU, respectively. The mean procedure, fluoroscopy, and hospitalization times were 75.2 +/- 35.3 min, 133.4 +/- 92.3 s, and 3.5 +/- 2.1 days, respectively. Stone-free status was achieved in 106 cases (77.4 %). A total of 17 (13.6 %) complications occurred postoperatively. The mean scores were 2.7, 7.2, and 219.1, for the Guy, S.T.O.N.E., and CROES systems, respectively. CROES score was the independent predictor of PNL success in cases with anatomical abnormalities [p: 0.001, OR 1.01, (95 % CI 1005-1021)]. The CROES scoring system is well correlated with the success of PNL in cases with anatomical abnormalities; the S.T.O.N.E. and Guy scoring systems failed to predict the outcomes of PNL in this specific patient population.