title: Evaluation of stone-free rate using Guy's Stone Score and assessment of complications using modified Clavien grading system for percutaneous nephro-lithotomy.
abstract: To prospectively evaluate the ability of Guy's Stone Score (GSS) in predicting stone clearance rate and complication rate (by modified Clavien grade) for renal stones treated by percutaneous nephrolithotomy (PNL). From January 2013 to June 2014, a total of 142 patients undergoing PNL were evaluated prospectively. Patients with co-morbidities like hypertension, diabetes, renal failure were excluded from the study. All patients were classified according to GSS based on the findings of pre-operative intravenous urography (IVU) and per-operative retrograde pyelography (RGP). All PNL procedures were done by standard technique in prone position and success was defined as no residual stone visible on X-ray KUB done on the third postoperative day. Complications were classified according to modified Clavien grading system. The initial stone clearance rate was 71.1% and overall final stone clearance rate was 90.14%. The complication rate according to Clavien grading system was 40.1%. The final stone clearance rates were 93.9, 85.71, 90.47, and 77.77% in GSS I, II, III, and IV, respectively (p<0.001, <0.05, <0.05 and >0.05, respectively). The Clavien complication rates were 23, 61, 52, and 77.7% in GSS I, II, III, and IV, respectively (p<0.001). The GSS is a simple and easily reproducible system to preoperatively predict stone-free rate and perioperative complication rate. It helps in better patient counseling preoperatively.
authors: Department of Urology, Calcutta National Medical College, Kolkata, 700014, India, rajan_rims@yahoo.co.in.
authors: Rajan Kumar
authors: RK
authors: Sinha
authors: Subhabrata
authors: S
authors: Mukherjee
authors: Tarun
authors: T
authors: Jindal
authors: Pramod Kumar
authors: PK
authors: Sharma
authors: Barun
authors: B
authors: Saha
authors: Nilanjan
authors: N
authors: Mitra
authors: Jay
authors: J
authors: Kumar
authors: Chandranath
authors: C
authors: Mukhopadhyay
authors: Nabankur
authors: N
authors: Ghosh
authors: Mir Reza
authors: MR
authors: Kamal
authors: Soumendra Nath
authors: SN
authors: Mandal
authors: Dilip
authors: D
authors: Karmakar
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012720:Severity of Illness Index