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PCNL, a minimally invasive surgical technique for kidney stone removal, relies on achieving stone-free status, which various scoring systems aim to predict. This study assesses the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES) and Guy’s Stone Score (GSS) systems in determining stone-free rates following percutaneous nephrolithotomy (PCNL) in pediatric patients. A retrospective analysis was conducted on 580 pediatric patients who underwent PCNL at Çukurova University Urology Clinic between January 2007 and March 2024. Patients were categorized into two groups based on postoperative stone status: Group 1 and Group 2. CROES and GSS scores were calculated for each patient. The association between these scores and stone-free status, as well as postoperative complications, was statistically analyzed. Additionally, subgroup analyses were performed based on age groups. The study showed that 83.7% of patients achieved a stone-free condition postoperatively. Significant differences were found between the stone-free and residual stone groups regarding stone burden and operative time ( p  <  0.001 ). CROES had high accuracy for predicting stone-free outcomes ( p  <  0.001 ), while GSS was also effective in predicting both stone-free rates and complications. CROES was less effective in predicting complications. Both CROES and GSS are valuable for predicting PCNL outcomes in pediatric patients. While CROES is more reliable for stone-free rates, GSS better predicts complications. However, their limitations highlight the need for pediatric-specific scoring models. Until such models are developed, these systems should be used with caution alongside individualized clinical assessments.

The aim of this study was validation and comparison of stone scoring systems (S.T.O.N.E, GUY, CROES, S-ReSC) used to predict postoperative stone-free status and complications after percutaneous nephrolithotomy (PCNL) for staghorn stones. A total of 160 patients who had staghorn renal stones and underwent PCNL between January 2012 and August 2015 were included in the current retrospective study. Guy, S.T.O.N.E., S-ReSC (Seoul National University Renal Stone Complexity) and CROES (Clinical Research Office of the Endourological Society) nephrolithometry scores were calculated for each patient, and their potential association with stone-free status, operative and fluoroscopy time, and length of hospital stay (LOS) were evaluated. Postoperative complications were graded according to the modified Clavien classification, and the correlation of scoring systems with postoperative complications was also investigated. The mean CROES, S.T.O.N.E, Guy and S-ReSC scores were 143.5 ± 33.6, 9.7 ± 1.6, 3.5 ± 0.5 and 6.2 ± 2.0 respectively. The overall stone-free rate was 59%. All scoring systems were significantly correlated with stone-free status in univariate analysis. However, Guy and S-ReSC scores were the only significant independent predictor in multivariate analysis. And all four nomograms failed to predict complication rates. Current study demonstrated that Guy and S-ReSC scoring systems could effectively predict postoperative stone-free status for staghorn stones. However all four scoring systems failed to predict complication rates.

In this study, we aim to evaluate the accuracy of STONE (stone size, tract length, obstruction, number of involved calyces, and essence/stone density), Clinical Research Office of the Endourological Society (CROES), and Guy’s nephrolithometry scoring systems (NSS) in obese patients. The charts of patients who underwent percutaneous nephrolithotomy (PNL) between June 2008 and June 2016 were retrospectively analyzed. Calculations of the STONE, CROES, and Guy’s NSS were performed by a resident who was well informed regarding each NSS. Patients were classified under nine scores according to STONE, four grades according to CROES, and four grades according to Guy’s NSS. In total, 248 obese patients were enrolled in the study. Stone size was significantly higher in patients without stone-free status (p = 0.001). In patients who were stone-free and those with residual stones, the mean STONE score was 9.71 and 9.23 (p = 0.160), CROES was 172 and 129 (p = 0.001), and Guy’s NSS was 1.67 and 2.75 (p = 0.001). Multivariate regression analysis identified the CROES and Guy’s NSS were independent factors for PNL success in obese patients (p = 0.01 and p = 0.01, respectively). The CROES and Guy’s NSS showed good accuracy with PNL success (AUC = 0.777 and AUC = 0.844, respectively). None of the three NSS systems were statically associated with a complication rate (p = 0.23 for STONE, p = 0.14 for CROES, and p = 0.51 for Guy’s NSS). Our study demonstrated that CROES and Guy’s NSS were independent predictors of stone-free rate following PNL in obese patients. Our study also revealed that three of the NSSs were not useful for predicting PNL complications in obese patients.

ObjectiveAuxiliary nephrolithometric scoring systems (NSSs) have been developed to predict complications and treatment success of conventional percutaneous nephrolithotomy (PCNL). However, to our knowledge, there is no study comparing these NSSs in patients undergoing miniPCNL. This study aimed to compare the NSSs in terms of their ability to predict miniPCNL-related complications and treatment success.MethodsThe data of patients undergoing PCNL between September 2016 and May 2018 were retrospectively reviewed through the electronic medical record system, and 140 patients were included in our study. Stone-free status was evaluated using non-contrast computed tomography between 1 and 3 months after the procedure. PCNL was considered successful if the patient was completely stone free. The postsurgical complications were classified according to the modified Clavien–Dindo classification system.ResultsThe Clinical Research Office of the Endourological Society (CROES) and STONE NSSs significantly predicted miniPCNL treatment success (p = 0.043, p = 0.018). However, the Guy’s NSS did not significantly predict the treatment success (p = 0.415). Guy’s, CROES and STONE NSSs were not found to significantly predict postsurgical complications (p = 0.584, p = 0.823, p = 0.189).ConclusionTo the best of our knowledge, our study is the first of its kind to investigate the ability of NSSs to predict treatment success and postsurgical complications in patients undergoing miniPCNL. The study found that STONE and CROES NSSs are independent parameters for predicting stone-free status after miniPCNL. In addition, our study found that none of the NSSs were useful in predicting postsurgical complications in patients undergoing miniPCNL.