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Increasing stone complexity does not affect fluoroscopy time in percutaneous nephrolithotomy.

Annah Vollstedt1, Johann Ingimarsson2, Lawrence Dagrosa3

  • 1Dartmouth Hitchcock Medical Center, One Medical Center Drive, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA.

Therapeutic Advances in Urology
|May 7, 2019
PubMed
Summary
This summary is machine-generated.

Guy's stone score (GSS) complexity did not correlate with intraoperative fluoroscopy time (FT) during percutaneous nephrolithotomy. This suggests complex kidney stones can be treated without significantly increasing radiation exposure.

Keywords:
Guy’s stone scorefluoroscopypercutaneous nephrolithotomyradiationstone complexity

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Area of Science:

  • Urology
  • Nephrolithiasis Management
  • Medical Imaging

Background:

  • Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
  • Minimizing intraoperative radiation exposure is a key concern in PCNL.
  • The Guy's stone score (GSS) is used to classify kidney stone complexity.

Purpose of the Study:

  • To determine if kidney stone complexity, as measured by the Guy's stone score (GSS), is associated with increased intraoperative fluoroscopy time (FT) during PCNL.

Main Methods:

  • Retrospective review of 203 PCNL cases with available CT staging and fluoroscopy data.
  • Kidney stone complexity assessed using the Guy's stone score (GSS).
  • Correlation between GSS and fluoroscopy time (FT) analyzed using univariate and multivariate regression, controlling for patient and procedural factors.

Main Results:

  • No statistically significant correlation was found between GSS and FT (r=0.04, p=0.55).
  • Multivariate analysis, including age, sex, BMI, and number of accesses, also showed no significant association between stone complexity and FT (p=0.893).
  • A correlation was noted between operative time and FT, and a trend towards increased operative time with higher GSS.

Conclusions:

  • Kidney stone complexity, as defined by GSS, does not correlate with intraoperative fluoroscopy time in PCNL.
  • Treatment of complex kidney stones via PCNL can be performed without an inevitable increase in fluoroscopy exposure.
  • These findings support efforts to reduce radiation exposure during PCNL for complex stones.