A new tool for predicting the efficiency of mini-percutaneous nephrolithotomy
- Authors: Magomedov D.M.1,2, Kotov S.V.1,2,3, Pulbere S.A.1,2, Bolotov A.D.1,2, Gradskova T.E.1
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Affiliations:
- FGAOU VO N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia
- Pirogov City Clinical Hospital No.1
- «Kommunarka» Moscow Multidisciplinary Clinical Center of Moscow Health Department
- Issue: No 1 (2025)
- Pages: 60-67
- Section: Endourology
- URL: https://journals.eco-vector.com/1728-2985/article/view/687337
- DOI: https://doi.org/10.18565/urology.2025.1.60-67
- ID: 687337
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Abstract
Introduction. Currently, percutaneous nephrolithotomy (PCNL) is a first-line treatment method for large and staghorn kidney stones. Predicting the efficiency of the performed surgical procedure is relevant at the stage of preoperative counseling of patients.
Aim. To develop a universal nomogram for predicting the efficiency of mini-PCNL taking into account the baseline characteristics and features of the patient.
Materials and methods. A total of 251 patients with kidney stones who underwent mini-PCNL in the prone position according to the standard method through a single access were included in the study. The preoperative characteristics of patients and their impact on the outcome were evaluated. An achievement of the stone-free rate (SFR) was assessed by the computed tomography (CT).
Results. The analysis revealed factors significantly influencing the achievement of the SFR, such as stone volume >1.39 cm3 (p=0.001), stone area >189.03 mm2 (p=0.001), distance from the lowest point of the Th12 to the lower part of the lower pole calyx (T12-LP) <85.81 mm (p=0.050), distances from the lower calyx to the most cranial part of the iliac crest (ICLP) >49.1 mm (p=0.029), stone size >18.2 mm (p=0.001), number of involved calyxes >3 (p=0.001), number of involved calyxes for staghorn stones >4 (p=0.001), and staghorn stone (p=0.001). Correlation, logistic regression, and ROC analysis were performed for these factors. The area under the curve (AUC) was 0.897. A nomogram has been developed. The sensitivity of the model is 94.4%, specificity is 59.2%, and overall accuracy is 84.4%. A certificate of state registration of a computer program in the IBM SPSS Statistics syntax language "A model for predicting the SFR of mini-PCNL in patients with kidney stones" was obtained.
Conclusion. The nomogram developed on the basis of our data showed a high predictive ability in relation to the SFR with sensitivity of 94%. This nomogram is easy to use and interpret, which makes it convenient for routine practice, however, external validation is necessary to objectify the predictive ability.
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About the authors
Dzhanay M. Magomedov
FGAOU VO N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia; Pirogov City Clinical Hospital No.1
Author for correspondence.
Email: magomedov.dzhanay@yandex.ru
ORCID iD: 0000-0002-9905-5110
Ph.D. student of the Department of Urology and Andrology, Urologist at the Urologic Department
Russian Federation, Moscow; MoscowSergey V. Kotov
FGAOU VO N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia; Pirogov City Clinical Hospital No.1; «Kommunarka» Moscow Multidisciplinary Clinical Center of Moscow Health Department
Email: urokotov@mail.ru
ORCID iD: 0000-0003-3764-6131
Ph.D., MD, professor, Head of the Department of Urology and Andrology, Urologist at the Urologic Department, Head of University Clinic of Urology, Oncourology and Andrology
Russian Federation, Moscow; Moscow; MoscowSergey A. Pulbere
FGAOU VO N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia; Pirogov City Clinical Hospital No.1
Email: pulpiv@mail.ru
ORCID iD: 0000-0001-7727-4032
Ph.D., MD, associate professor, Professor at the Department of Urology and Andrology, Head of the Department of Urology
Russian Federation, Moscow; MoscowAndrey D. Bolotov
FGAOU VO N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia; Pirogov City Clinical Hospital No.1
Email: adbolotov@gmail.com
ORCID iD: 0000-0002-8142-9495
Ph.D., urologist at the Department of Urology, Assistant at the Department of Urology and Andrology
Russian Federation, Moscow; MoscowTatyana E. Gradskova
FGAOU VO N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia
Email: tatynaeg@ya.ru
ORCID iD: 0009-0005-1838-473X
student
Russian Federation, MoscowReferences
- Mamaev I.E., Akhmedov K.K., Dolomanov K.A., Saipulaev G.Sh., Manuilova O.O., Stepanenko K.V., Savkina K.V., Kotov S.V. Mini-subcutaneous nephrolithotomy without ureter catheterization. Comparison with the standard methodology. Eksperimentalnaya i klinicheskaya urologiya, 2021;14(2):58-63; https://doi.org/10.29188/2222-8543-2021-14-2-58-63. Russian (Мамаев И.Э., Ахмедов К.К., Доломанов К.А., Сайпулаев Г.Ш., Мануйлова О.О., Степаненко К.В., Савкина К.В., Котов С.В. Мини-перкутанная нефролитотомия без катетеризации мочеточника. Сравнение со стандартной методикой. Экспериментальная и клиническая урология. 2021;14(2):58–63. https://doi.org/10.29188/2222-8543-2021-14-2-58-63).
- Kotov S.V., Belomyttsev S.V., Mamaev I.E., Perov R.A., Pulbere S.A., Surenkov D.N. The evolution of approaches in the treatment of urolithiasis. Multicenter analysis of the work of 5 urological departments of multidisciplinary hospitals in Moscow. Eksperimentalnaya i klinicheskaya urologiya 2020;13(5):51-58, https://doi.org/10.29188/2222-8543-2020-13-5-51-58. Russian (Котов С.В., Беломытцев С.В., Мамаев И.Э., Перов Р.А., Пульбере С.А., Суренков Д.Н. Эволюция подходов в лечении мочекаменной болезни. Мультицентровой анализ работы 5 урологических отделений многопрофильных стационаров г. Москвы. Экспериментальная и клиническая урология. 2020;13(5):51-58. https://doi.org/10.29188/2222-8543-2020-13-5-51-58).
- Gadzhiev N.K., Grigorev V.E., Mazurenko D.A., Malhasyan V.A., Obidnyak V.M., Pisarev A.V., Tagirov N.S., Popov S.V., Petrov S.B. The ACS system or a new method for predicting the effectiveness of percutaneous nephrolithotomy. Eksperimentalnaya i klinicheskaya urologiya 2016;3:52–56. Russian (Гаджиев Н.К., Григорьев В.Е., Мазуренко Д.А., Малхасян В.А., Обидняк В.М., Писарев А.В., Тагиров Н.С., Попов С.В., Петров С.Б. Система ACS или новый способ прогнозирования эффективности перкутанной нефролитотомии. Экспериментальная и клиническая урология. 2016;3:52–56).
- Smith A., Averch T.D., Shahrour K., Opondo D., Daels F.P.J., Labate G. et al. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol 2013;190(1):149–56.
- Okhunov Z., Friedlander J.I., George A.K., Duty B.D., Moreira D.M., Srinivasan A.K. et al. S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology 2013;81(6):1154–1159.
- Mishra S., Sabnis R.B., Desai M. Staghorn morphometry: a new tool for clinical classification and prediction model for percutaneous nephrolithotomy monotherapy. J Endourol. 2012;26(1):6–14.
- Thomas K., Smith N.C., Hegarty N., Glass J.M. Guy’s stone score-grading the complexity of percutaneous nephrolithotomy procedures. Urology. 2011;78(2):277–81.
- Jeong C.W., Jung J.-W., Cha W.H., Lee B.K., Lee S. et al. Seoul National University Renal Stone Complexity Score for Predicting Stone-Free Rate after Percutaneous Nephrolithotomy. PLoS ONE. 2013; 8(6): e65888. doi: 10.1371/journal.pone.0065888
- Elkoushy M.A., Metwally A.H., Noureldin Y.A. Implications of different nephrolithometry scoring systems on clinical practice of endourologists: an international web-based survey. Arab J Urol. 2016;14:216–222.
- Gorelov D.S., Gadzhiev N.K., Akopyan G.N., Ivanov A.O., Schukin V.L., Talyshinskiy A.V., Petrov S.B. Residual stones after PNL: problems of diagnosis and treatments (literature review) Eksperimentalnaya i klinicheskaya urologiya. 2019;1:57–63. doi: 10.29188/2222-8543-2019-11-1-57-62. Russian (Горелов Д.С., Гаджиев Н.К., Акопян Г.Н., Иванов А.О., Щукин В.Л., Талышинский А.В., Петров С.Б. Резидуальные камни после ПНЛ: проблемы диагностики и лечения (обзор литературы) Экспериментальная и клиническая урология. 2019;1:57–63 doi: 10.29188/2222-8543-2019-11-1-57-62).
- Panferov A.S., Kotov S.V., Safiullin R.I. Analysis of changes in the quality of life of patients with bilateral nephrolithiasis after simultaneous and staged bilateral mini-percutaneous nephrolithotomy. Experimental and clinical urology. 2019;1:64–69. doi: 10.29188/2222-8543-2019-11-1-64-69. Russian (Панферов А.С., Котов С.В., Сафиуллин Р.И. Анализ изменения качества жизни пациентов с двусторонним нефролитиазом после одномоментной и этапной билатеральной мини-перкутанной нефролитотомии. Экспериментальная и клиническая урология. 2019;1:64–69. doi: 10.29188/2222-8543-2019-11-1-64-69).
- Emmott A.S., Brotherhood H.L., Paterson R.F., Lange D., Chew B.H. Complications, re-intervention rates, and natural history of residual stone fragments after percutaneous nephrolithotomy J Endourol. 2018;32(1):28–32. doi: 10.1089/end.2017.0618.
- Delvecchio F.C., Preminger G.M. Management of residual stones. Urol Clin North Am. 2000;27(2):347–354.
- Raman J.D., Bagrodia A, Gupta A, Bensalah K, Cadeddu J.A., Lotan Y. Natural history of residual fragments following percutaneous nephrostolithotomy. J Urol. 2009;181(3):1163–68. doi: 10.1016/j.juro.2008.10.162.
- Bibi M., Sellami A., Chaker K., Ouanes Y., Kheiredine M.D., Ben Chehida M.A., Ben Rhouma S., Nouira Y. Les scores radiologiques peuvent-t-ils prédire le succès de la NLPC ? Étude comparative du Guy’s stone score, du STONE score, du CROES nomogram, et du S-ReSc score [Do the nephrolithometry scoring systems predict the success of percutaneous nephrolithotomy. Comparison of 4 scores: The Guy’s stone score, STONE Score, CROES nomogram and S-ReSC score]. Prog Urol. 2019;29(8-9):432–439.. doi: 10.1016/j.purol.2019.05.007. Epub 2019 Jun 11. PMID: 31196827
- Al Adl A.M., Mohey A., Abdel Aal A., Abu-Elnasr H.A.F., El Karamany T., Noureldin Y.A. Percutaneous Nephrolithotomy Outcomes Based on S.T.O.N.E., GUY, CROES, and S-ReSC Scoring Systems: The First Prospective Study. J Endourol. 2020;34(12):1223–1228. doi: 10.1089/end.2019.0856. Epub 2020 Mar 23. PMID: 32098495
- Biswas K., Gupta S.K., Tak G.R., Ganpule A.P., Sabnis R.B., Desai M.R. Comparison of STONE score, Guy’s stone score and Clinical Research Office of the Endourological Society (CROES) score as predictive tools for percutaneous nephrolithotomy outcome: a prospective study. BJU Int. 2020;126(4):494–501. doi: 10.1111/bju.15130. Epub 2020 Aug 4. PMID: 32506712.
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