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A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery

Objectives: The aim of this study was to evaluate the level of hematuria and the presence of clots during retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mPCNL) to predict surgical outcomes. Materials and Methods: The data of patients who underwent RIRS and mPCNL...

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Autores principales: Kim, Gyeong Hun, Jung, Gyoohwan, Suh, Jungyo, Park, Juhyun, Cho, Sung Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142515/
https://www.ncbi.nlm.nih.gov/pubmed/37109157
http://dx.doi.org/10.3390/jcm12082820
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author Kim, Gyeong Hun
Jung, Gyoohwan
Suh, Jungyo
Park, Juhyun
Cho, Sung Yong
author_facet Kim, Gyeong Hun
Jung, Gyoohwan
Suh, Jungyo
Park, Juhyun
Cho, Sung Yong
author_sort Kim, Gyeong Hun
collection PubMed
description Objectives: The aim of this study was to evaluate the level of hematuria and the presence of clots during retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mPCNL) to predict surgical outcomes. Materials and Methods: The data of patients who underwent RIRS and mPCNL were analyzed separately. A hematuria grading (HG) system was classified into five grades based on the presence of blood clots and any visible stones according to the irrigation settings. Inter-observer reliability of the grading system was assessed using intra-class correlation and Spearman’s rho. Results: The HG system showed high agreement among examiners, with high intra-class reliability and a strong correlation between RIRS and mPCNL groups. The stone density of the Houns-field unit was the most important factor in determining the hematuria across the development and validation groups of RIRS and mPCNL patients. Multivariate logistic regression analysis showed that the HG system was a significant predictor for remnant stones in the PCNL group and the probability of acute pyelonephritis or sepsis in the RIRS group. The high hematuria group showed lower basketing difficulty with the basket with a blue marker instrument than with others. Conclusions: The new HG system shows excellent inter-observer reliability and a correlation with a gradual increase in stone density and surgical difficulty.
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spelling pubmed-101425152023-04-29 A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery Kim, Gyeong Hun Jung, Gyoohwan Suh, Jungyo Park, Juhyun Cho, Sung Yong J Clin Med Article Objectives: The aim of this study was to evaluate the level of hematuria and the presence of clots during retrograde intrarenal surgery (RIRS) and miniaturized percutaneous nephrolithotomy (mPCNL) to predict surgical outcomes. Materials and Methods: The data of patients who underwent RIRS and mPCNL were analyzed separately. A hematuria grading (HG) system was classified into five grades based on the presence of blood clots and any visible stones according to the irrigation settings. Inter-observer reliability of the grading system was assessed using intra-class correlation and Spearman’s rho. Results: The HG system showed high agreement among examiners, with high intra-class reliability and a strong correlation between RIRS and mPCNL groups. The stone density of the Houns-field unit was the most important factor in determining the hematuria across the development and validation groups of RIRS and mPCNL patients. Multivariate logistic regression analysis showed that the HG system was a significant predictor for remnant stones in the PCNL group and the probability of acute pyelonephritis or sepsis in the RIRS group. The high hematuria group showed lower basketing difficulty with the basket with a blue marker instrument than with others. Conclusions: The new HG system shows excellent inter-observer reliability and a correlation with a gradual increase in stone density and surgical difficulty. MDPI 2023-04-12 /pmc/articles/PMC10142515/ /pubmed/37109157 http://dx.doi.org/10.3390/jcm12082820 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Gyeong Hun
Jung, Gyoohwan
Suh, Jungyo
Park, Juhyun
Cho, Sung Yong
A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery
title A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery
title_full A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery
title_fullStr A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery
title_full_unstemmed A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery
title_short A Newly Developed Hematuria Grading System May Predict the Status of Stone-Free and Acute Pyelonephritis of Minimally Invasive Renal Stone Surgery
title_sort newly developed hematuria grading system may predict the status of stone-free and acute pyelonephritis of minimally invasive renal stone surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142515/
https://www.ncbi.nlm.nih.gov/pubmed/37109157
http://dx.doi.org/10.3390/jcm12082820
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