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Urolithiasis

, Volume 47, Issue 6, pp 557–565 | Cite as

Do 3D-calculated volume distribution of a stone in pelvicalyceal system affect complications of percutaneous nephrolithotomy?

  • Sait ÖzbirEmail author
  • Hasan Anıl Atalay
  • Halil Lütfi Canat
  • Mehmet Gökhan Çulha
Original Paper

Abstract

In our study, we examined the effect of the three-dimensional (3D) stone segmentation volume and its ratio to the renal collecting system on complication rates. Data from141 patients who underwent PCNL surgery were analyzed retrospectively. Volume segmentation of both the renal collecting system and stones was obtained from 3D segmentation software with the images on CT data. After creation of a 3D surface volume rendering of renal stones and the collecting system, segmentation of the renal collecting system volume (RCSV) and analyzed stone volume (ASV) was analyzed and the ASV-to-RCSV ratio was calculated. Univariate analysis and multivariate logistic regression model were used to determine factors that affected complication status. Diagnostic value for the prediction of complication rates was analyzed using receiver operating characteristic (ROC) incline. Overall, there were 141 (92 male and 49 female) eligible patients included in the current study. The overall complication rate for PCNL monotherapy was 31.9%. Multivariate regression analysis (forward stepwise) revealed that the ASV-to-RCSV ratio and number of tracts were independent risk factors for developing complications (OR 1.17, p < 0.001; OR 7.87, p = 0.002; respectively). The ROC analysis revealed a cut-off value of 16.23% (AUC 0.869, p < 0.001, sensitivity 93.3%, specificity 78.1%) for the ASV-to-RCSV ratio. The distribution of stone burden volume in the pelvicalyceal system, which is calculated as a numerical value using the 3D volume segmentation method, is an important predictor of the complication rate before PCNL. The ASV-to-RCSV ratio as a quantitative value may be an instrument for urologists before surgery to help preoperative planning.

Keywords

Percutaneous nephrolithotomy 3D volume segmentation Complication Three dimensions 

Abbreviations

AUC

Area under curve

ASV

Analyzed stone burden volume

BMI

Body mass index

CT

Computed tomography

DICOM

Digital imaging and communications in medicine

OR

Odds ratio

PCNL

Percutaneous nephrolithotomy

RCS

Renal collecting system volume

ROC

Receiver operating characteristic

3D

Three dimensional

Notes

Compliance with ethical standards

Conflict of interest

Sait Özbir, Hasan Anıl Atalay, Halil Lütfi Canat and Mehmet Gökhan Çulha each declare no potential conflicts of interest.

References

  1. 1.
    Fernström I, Johansson B (1976) Percutaneous Pyelolithotomy. Scand J Urol Nephrol 10:257–259.  https://doi.org/10.1080/21681805.1976.11882084 CrossRefPubMedGoogle Scholar
  2. 2.
    PREMINGER GM, ASSIMOS DG, LINGEMAN JE et al (2018) AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 173:1991–2000.  https://doi.org/10.1097/01.ju.0000161171.67806.2a CrossRefGoogle Scholar
  3. 3.
    Turk C, Petrik A, Sarica K et al (2015) EAU guidelines on urolithiasis. Eur Assoc Urol 69:475–482.  https://doi.org/10.1159/000049803 CrossRefGoogle Scholar
  4. 4.
    Vicentini FC, Marchini GS, Mazzucchi E et al (2014) Utility of the Guy’s stone score based on computed tomographic scan findings for predicting percutaneous nephrolithotomy outcomes. Urology 83:1248–1253.  https://doi.org/10.1016/j.urology.2013.12.041 CrossRefPubMedGoogle Scholar
  5. 5.
    J. F ZO, D. M, et al (2012) S.T.O.N.E. nephrolithometry: a novel surgical classification system for renal stones. J Endourol 26:A239–A240.  https://doi.org/10.1089/end.2012.2001 CrossRefGoogle Scholar
  6. 6.
    Turna B, Umul M, Demiryoguran S et al (2007) How do increasing stone surface area and stone configuration affect overall outcome of percutaneous nephrolithotomy? J Endourol 21:34–43.  https://doi.org/10.1089/end.2005.0315 CrossRefPubMedGoogle Scholar
  7. 7.
    Atalay HA, Canat L, Bayraktarlı R et al (2017) Evaluation of stone volume distribution in renal collecting system as a predictor of stone-free rate after percutaneous nephrolithotomy: a retrospective single-center study. Urolithiasis.  https://doi.org/10.1007/s00240-017-0995-9 CrossRefPubMedGoogle Scholar
  8. 8.
    De La Rosette JJMCH, Opondo D, Daels FPJ et al (2012) Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 62:246–255.  https://doi.org/10.1016/j.eururo.2012.03.055 CrossRefPubMedGoogle Scholar
  9. 9.
    de la Rosette JJMCH, Assimos D, Desai M et al (2011) The clinical research office of the endourological society percutaneous nephrolithotomy global study. J Endourol 25:11–17.  https://doi.org/10.1089/end.2011.0169 CrossRefPubMedGoogle Scholar
  10. 10.
    Michel MS, Trojan L, Rassweiler JJ (2007) Complications in percutaneous nephrolithotomy. Eur Urol 51:899–906.  https://doi.org/10.1016/j.eururo.2006.10.020 CrossRefPubMedGoogle Scholar
  11. 11.
    Olbert PJ, Hegele A, Schrader AJ et al (2007) Pre- and perioperative predictors of short-term clinical outcomes in patients undergoing percutaneous nephrolitholapaxy. Urol Res 35:225–230.  https://doi.org/10.1007/s00240-007-0112-6 CrossRefPubMedGoogle Scholar
  12. 12.
    Sergeyev I, Koi PT, Jacobs SL et al (2007) Outcome of percutaneous surgery stratified according to body mass index and kidney stone size. Surg Laparosc Endosc Percutaneous Tech 17:179–183CrossRefGoogle Scholar
  13. 13.
    Turna B, Nazli O, Demiryoguran S et al (2007) Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 69:603–607.  https://doi.org/10.1016/j.urology.2006.12.021 CrossRefPubMedGoogle Scholar
  14. 14.
    Xue W, Pacik D, Boellaard W et al (2012) Management of single large nonstaghorn renal stones in the CROES PCNL global study. J Urol.  https://doi.org/10.1016/j.juro.2011.11.113 CrossRefPubMedGoogle Scholar
  15. 15.
    El-Nahas AR, Eraky I, Shokeir AA et al (2012) Factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone. Urology 79:1236–1241.  https://doi.org/10.1016/j.urology.2012.01.026 CrossRefPubMedGoogle Scholar
  16. 16.
    Gadzhiev N, Brovkin S, Grigoryev V et al (2015) Sculpturing in urology, or how to make percutaneous nephrolithotomy easier. J Endourol 29:512–517.  https://doi.org/10.1089/end.2014.0656 CrossRefPubMedGoogle Scholar
  17. 17.
    Jeong CW, Jung JW, Cha WH et al (2013) Seoul National University Renal Stone Complication Score for predicting stone-free rate after percutaneous nephrolithotomy. PLoS One 8:.  https://doi.org/10.1371/journal.pone.0065888 CrossRefGoogle Scholar
  18. 18.
    Goel A, Kathpalia R, Dalela D et al (2012) Prospective evaluation of complications using the modified Clavien grading system, and of success rates of percutaneous nephrolithotomy using Guy′s Stone Score: a single-center experience. Indian J Urol 28:392.  https://doi.org/10.4103/0970-1591.105749 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Ozgor F, Yanaral F, Savun M et al (2017) Comparison of STONE, CROES and Guy’s nephrolithometry scoring systems for predicting stone-free status and complication rates after percutaneous nephrolithotomy in obese patients. Urolithiasis.  https://doi.org/10.1007/s00240-017-1003-0 CrossRefPubMedGoogle Scholar
  20. 20.
    Kumar U, Tomar V, Yadav SS et al (2018) STONE score versus Guy’s Stone Score—prospective comparative evaluation for success rate and complications in percutaneous nephrolithotomy. Urol Ann 10:76–81.  https://doi.org/10.4103/UA.UA_119_17 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyOkmeydanı Training and Research HospitalIstanbulTurkey

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