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All Journal e-CliniC Medical Scope Journal (MSJ) International Journal of Health and Pharmaceutical (IJHP)
Wihono, Frendy
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health

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Journal : Medical Scope Journal (MSJ)

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Comparison of Scoring Systems in Predicting Stone-Free Rate in Flourless Retrograde Intrarenal Surgery Arianto, Eko; Astram, Ari; Toreh, Christof; Wihono, Frendy; Krishna, Mahesa
Medical Scope Journal Vol. 7 No. 1 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i1.57388

Abstract

Abstract: Thus far, there is no standardised method for predicting outcomes from fluoro-less retrograde intrarenal surgery (RIRS) procedure. This study aimed to compare scoring systems in predicting stone-free rate (SFR) in RIRS patients This was an observational and analytical study with a retrospective cohort design. Samples were obtained from medical records of  Dr. J. H. Awaloei Hospital from March 2022 to October 2023. This study only analyzed three scoring systems: Guy's Stone Score (GSS), Resorlu-Unsal Stone Score (RUSS), and Seoul National University Renal Stone Complexity Score (S-ReSC). The results obtained 219 patients with an average age of 55 years, GSS grade I in 108 patients, and grade II in 50 patients. Related to RUSS score, 43 patients got a score of 1, 108 got a score of 2, and 60 got a score of 60. Meanwhile, S-ReSC score was at a high level with a percentage of 65.3%, 20.4% at the medium level, and 14.4% at the low level. Moreover, GSS sensitivity 76%, specificity 75%, PPV 93.2%, NPV 41.1%, AUC 75%; RUSS score sensitivity 75.4%, specificity 62.2%, PPV 90%, NPV 36.2%, AUC 70%; S-ReSC score sensitivity 71%, specificity 77.5%, PPV 93.4%, NPV 37.3%, AUC 72%. In conclusion, Guy's Stone Score, Resorlu-Unsal Stone Score, and Seoul National University Renal Stone Complexity Score have similar abilities in predicting stone-free rate. Further research is needed with a larger sample size or population to confirm the findings of this study. Keywords: nephrolithiasis; stone-free rate; scoring system; retrograde intrarenal surgery
Validation of Guy’s Stone Score, RUSS, S-RESC SCORE, and S.T.O.N.E Score for Predicting Stone Free Rate in Percutaneous Nephrolithotomy in a Residency Teaching Hospital Panelewen, Bryan P.; Arianto, Eko; Astram, Ari; Toreh, Christof; Wihono, Frendy
Medical Scope Journal Vol. 7 No. 2 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i2.61296

Abstract

Abstract: Kidney stones represent a significant health burden globally, with a high risk of recurrence. Percutaneous nephrolithotomy (PCNL) is the primary treatment option for kidney stones larger than 20 mm, offering superior outcomes compared to open surgery. Several scoring systems, including Guy’s Stone Score (GSS), S.T.O.N.E. Nephrolithometry Score, Resorlu Unsal Stone Score (RUSS), and Seoul Renal Stone Complexity (S-ReSC), have been developed to predict the Stone-Free Rate (SFR) following PCNL. However, the comparative effectiveness of these scoring systems remains unclear. This study aimed to evaluate and compare the predictive accuracy of GSS, S.T.O.N.E., RUSS, and S-ReSC scoring systems in determining SFR after PCNL. This was an analytical and retrospective study. Data were collected from 60 patients with kidney stones treated at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2023. Patients underwent PCNL, and preoperative non-contrast CT scans and postoperative plain abdominal X-rays were used for evaluation. Statistical analyses included univariate, bivariate, and multivariate tests, as well as ROC curve analysis. The results showed that all four scoring systems were statistically significant in predicting SFR (p<0.005). The RUSS score demonstrated the highest predictive value, with an odds ratio 20 times higher than without scoring. The ROC analysis showed AUC values of 0.792 for GSS, 0.913 for RUSS, 0.694 for S-ReSC, and 0.945 for S.T.O.N.E. These findings highlight significant relationships between stone complexity scores and SFR, emphasizing their utility in surgical planning. In conclusion, each scoring system has significant predictive value for SFR following PCNL. Among them, RUSS showed the highest reliability, followed by S.T.O.N.E. and GSS. Despite differences in focus, all scores contribute to treatment planning and patient management. Further research is needed to optimize these tools and integrate them with advanced imaging and minimally invasive techniques for personalized patient care. Keywords:  percutaneous nephrolithotomy; kidney stones; Stone-Free Rate; Guy’s Stone Score; S.T.O.N.E Nephrolithometry Score; Resorlu Unsal Stone Score; Seoul Renal Stone Complexity
Co-Authors Ari Astram, Ari ARIANTO, EKO Hardianti Kusanto, Putri Krishna, Mahesa Panelewen, Bryan P. Phoebus, Andrien R. Torry, Stivano Toreh, Christof