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• W1968971509 abstract "You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111545 NEPHROLITHOMETRY: A NOVEL SCORING SYSTEM FOR KIDNEY CALCULI Zhamshid Okhunov, Justin Friedlander, Brian Duty, Arvin George, Arun Srinivasan, Martin Lesser, Arthur Smith, and Zeph Okeke Zhamshid OkhunovZhamshid Okhunov New Hyde Park, NY More articles by this author , Justin FriedlanderJustin Friedlander New Hyde Park, NY More articles by this author , Brian DutyBrian Duty New Hyde Park, NY More articles by this author , Arvin GeorgeArvin George New Hyde Park, NY More articles by this author , Arun SrinivasanArun Srinivasan New Hyde Park, NY More articles by this author , Martin LesserMartin Lesser New Hyde Park, NY More articles by this author , Arthur SmithArthur Smith New Hyde Park, NY More articles by this author , and Zeph OkekeZeph Okeke New Hyde Park, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1553AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Instruments currently available to assess outcomes of percutaneous stone surgery are cumbersome, not validated, and of limited clinical utility. We propose a novel standardized scoring system to predict outcomes after percutaneous nephrolithotomy (PCNL). METHODS Five reproducible variables available from preoperative non-contrast computed tomography (CT) imaging were selected for the scoring system. These included stone volume, stone density, number of involved calyces, presence of hydronephrosis, and skin to stone distance. Scoring for each variable is outlined in Table 1. The scoring system was prospectively validated with 52 consecutive patients undergoing single-stage PCNL. Comparisons across categories were made using the Wilcoxon rank sum test (2 categories) or Kruskal-Wallis test (>2 categories). Spearman correlation was used to measure the degree of association between two continuous variables. Table 1. Nephrolithometry Scoring System Variables/Scores 1 2 3 Stone volume (mm3) ≤150 150–250 >250 Stone density (HU) ≤900 >900 Hydronephrosis Mild Moderate Severe Skin to stone distance ≤115 >115 Number of calyces Pelvis only, or 1 calyx involved Pelvis + >2 calyces Staghorn stone RESULTS Demographic, clinical, and operative data are included in Table 2. Mean nephrolithometry score was 6.6 (range 2–10). A lower score was found to be predictive of stone free status: 6.4 (stone free) vs. 8.2 (residual stone burden), p=0.002. Additionally, higher scores were significantly correlated with the duration of fluoroscopy time (p=0.001). There were no significant correlations with perioperative variables such as estimated blood loss, operative time, number of tract dilations, intraoperative complications, and postoperative complications within 30 days. Table 2. Demographic, clinical and operative data Gender (male/female) 29/23 Age (years, mean) 51(17–77) BMI (kg/m2, mean) 31(15–48) Stone volume (mm3, mean) 165(30–490) Stone density (HU, mean) 1038(295–2345) Hydronephrosis (yes/no) 21/17 Skin to stone distance (mm, mean) 105 Position (prone/supine) 49/3 OR time (minutes, mean) 99.5(50–180) EBL (mL, mean) 215(50–400) Fluoroscopy time (minutes, mean) 8.7(1.5–23.5) Complications (%) 6(11.5) Stone free rate (%) 46(88.5) LOS (days, mean) 2.9(2–10) CONCLUSIONS Nephrolithometry score can be used to successfully predict success of PCNL. Reproducible, standardized parameters obtained from CT imaging can be used to counsel patients preoperatively regarding stone free rates. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e620-e621 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zhamshid Okhunov New Hyde Park, NY More articles by this author Justin Friedlander New Hyde Park, NY More articles by this author Brian Duty New Hyde Park, NY More articles by this author Arvin George New Hyde Park, NY More articles by this author Arun Srinivasan New Hyde Park, NY More articles by this author Martin Lesser New Hyde Park, NY More articles by this author Arthur Smith New Hyde Park, NY More articles by this author Zeph Okeke New Hyde Park, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W1968971509 title "1545 NEPHROLITHOMETRY: A NOVEL SCORING SYSTEM FOR KIDNEY CALCULI" @default.
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