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Year : 2022  |  Volume : 11  |  Issue : 4  |  Page : 336-343

Comparative study between Guy's stone score, S.T.O.N.E nephrolithometry and Clinical Research Office of the Endourological Society (CROES) nephrolithometric nomogram in predicting stone-free rates in patients undergoing percutaneous nephrolithotomy: A prospective analysis

1 Department of Surgery, RDJM Medical College, Muzaffarpur, Bihar, India
2 Department of Urology, Narayana Medical College, Nellore, Andhra Pradesh, India
3 Department of Urology, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences, Andhra Pradesh, India

Correspondence Address:
Dr. Ershad Hussain Galeti
Department of Urology, Narayana Medical College, Nellore - 524 003, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdrntruhs.jdrntruhs_42_22

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Background: Several scoring systems have recently emerged to predict stone-free rates (SFRs) after percutaneous nephrolithotomy (PCNL). We aimed to compare the most commonly used scoring systems (Guy's stone score, STONE nephrolithometry and Clinical Research Office of the Endourological Society (CROES) nomogram) and assess their predictive accuracy for stone-free rates (SFRs). We also evaluated these scoring systems in their ability to predict perioperative complications, operative time (OT), length of hospital stay (LOH) and postoperative fall in haemoglobin. Methods: We prospectively evaluated 50 consecutive patients with renal calculi who underwent PCNL at our institute for two years. Preoperative CT was done in all the patients. We applied GSS, STONE nephrolithometry and CROES nomogram in all patients. The association of these scoring systems with SFR, perioperative complications, OT, LOH and fall in haemoglobin was evaluated. Results: The overall SFR in our study was 94%. The mean score of GSS, STONE and CROES was 1.66 ± 0.71, 7.08 ± 1.77 and 86.9 ± 4.35. GSS (AUC – 0.86) and S.T.O.N.E nephrolithometry (AUC – 0.837) score effectively predicted SFR, unlike CROES nomogram (AUC – 0.223). The overall complication rate was 54%. GSS (AUC – 0.643) and S.T.O.N.E nephrolithometry (AUC – 0.628) score effectively predicted post-operative complications, unlike CROES nomogram (AUC – 0.308). All three scoring systems (GSS, STONE and CROES) significantly correlated with OT (P < 0.01). None of the scoring systems correlated with LOH. GSS and CROES nomogram showed a weak correlation with fall in Hb. Conclusion: GSS and STONE nephrolithometry effectively predicted SFR and perioperative complication, unlike the CROES nomogram. All scoring systems correlated with OT. Scoring systems did not correlate with LOH. GSS and CROES nomogram weakly correlated with fall in haemoglobin.

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