Comparative analysis of scoring systems for patients undergoing retrograde intrarenal surgery with isolated lower calyx stones


Haberal H. B., İBİŞ M. A., Akpinar S., Uyanikoglu B., Ekmen H., Sadioglu F. E., ...Daha Fazla

WORLD JOURNAL OF UROLOGY, cilt.42, sa.1, 2024 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 42 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1007/s00345-024-05165-0
  • Dergi Adı: WORLD JOURNAL OF UROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, Gender Studies Database
  • Ankara Üniversitesi Adresli: Hayır

Özet

PurposeIt is critical to provide patients with accurate information on potential surgical outcomes during the preoperative phase. Several scoring systems have been developed for this specific purpose. This study aimed to examine the predicted efficacy of scoring systems in patients with isolated lower calyx stones who underwent retrograde intrarenal surgery (RIRS).MethodsWe performed a retrospective analysis of 85 patients who underwent RIRS for lower calyx stones between 2016 and 2023. The study computed each participant's Resorlu-Unsal Stone score (RUSS), R.I.R.S. scoring system score, Modified Seoul National University Renal Stone Complexity (S-ReSC) score, S.T.O.N.E. score, Ito's nomogram, and T.O.HO score. Residual stones less than 4 mm were classified as clinically insignificant residual fragments (CIRFs) and regarded as successful. Following that, we used receiver-operating characteristic (ROC) curves to compare various scoring systems' success predictions.ResultsThe median scores for RUSS, R.I.R.S. scoring system, Modified S-ReSC, S.T.O.N.E., Ito's nomogram, and T.O.HO score were 1 (1), 7 (2), 2 (0), 11 (1), 18 (4), and 7 (1), respectively. When CIRF cases were included, the stone-free rate increased to 80%. Only Ito's nomogram from scoring systems has a statistically significant cut-off value for success in ROC analysis (p = 0.021). In multivariate analysis, stone volume and preoperative hydronephrosis were associated with success (p = 0.004 and p = 0.035, respectively).ConclusionIn the multivariate analysis, none of the scoring systems were significantly associated with success. Hence, a new scoring system must be developed exclusively for patients with isolated lower pole stones undergoing RIRS.