Title

S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi

Publication Date

2013

Journal Title

Urology

Abstract

OBJECTIVE To, first, propose a novel scoring system to standardize reporting for percutaneous nephrolithotomy because the instruments currently available to predict the percutaneous nephrolithotomy outcomes are cumbersome, not validated, and of limited clinical utility; and, second, assess and predict the stone-free rates and perioperative parameters applying S.T.O.N.E. nephrolithometry. MATERIALS AND METHODS Five reproducible variables available from preoperative noncontrast-enhanced computed tomography were measured: stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E). RESULTS A total of 117 patients were included. The mean score was 7.7 (range 4-11). The stone-free rate after the first procedure was 80%. There were 18 complications (21%). The most frequent complications were postoperative sepsis and bleeding. The S.T.O.N.E. score correlated with the postoperative stone-free status (P = .001). The patients rendered stone free had statistically significant lower scores than the patients with residual stones (6.8 vs 9.7, P = .002). Additionally, the score correlated with the estimated blood loss (P = .005), operative time (P = .001), and length of hospital stay (P = .001). CONCLUSION The novel scoring system we have presented was found to predict treatment success and the risk of perioperative complications after percutaneous nephrolithotomy. Reproducible, standardized parameters obtained from computed tomography imaging can be used for preoperative patient counseling, surgical planning, and evaluation of surgical outcomes across institutions and within medical studies. (C) 2013 Elsevier Inc.

Volume Number

81

Issue Number

6

Pages

1154-1159

Document Type

Article

EPub Date

2013/04/02

Status

Faculty; Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

Urology

PMID

23540858

DOI

10.1016/j.urology.2012.10.083