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Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience

Background: Scoring metrics to assess and compare outcomes of percutaneous nephrolithotomy (PCNL) are needed. We aim to evaluate prevalence and predictors of trifecta in a cohort of patients treated with vacuum-assisted mini-percutaneous nephrolithotomy (vmPCNL) for kidney stones. Methods: Data from...

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Autores principales: Pozzi, Efrem, Malfatto, Matteo, Turetti, Matteo, Silvani, Carlo, Jannello, Letizia Maria Ippolita, Garbagnati, Susanna, Galbiati, Gilda, Zanetti, Stefano Paolo, Longo, Fabrizio, De Lorenzis, Elisa, Albo, Giancarlo, Salonia, Andrea, Montanari, Emanuele, Boeri, Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697932/
https://www.ncbi.nlm.nih.gov/pubmed/36431265
http://dx.doi.org/10.3390/jcm11226788
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author Pozzi, Efrem
Malfatto, Matteo
Turetti, Matteo
Silvani, Carlo
Jannello, Letizia Maria Ippolita
Garbagnati, Susanna
Galbiati, Gilda
Zanetti, Stefano Paolo
Longo, Fabrizio
De Lorenzis, Elisa
Albo, Giancarlo
Salonia, Andrea
Montanari, Emanuele
Boeri, Luca
author_facet Pozzi, Efrem
Malfatto, Matteo
Turetti, Matteo
Silvani, Carlo
Jannello, Letizia Maria Ippolita
Garbagnati, Susanna
Galbiati, Gilda
Zanetti, Stefano Paolo
Longo, Fabrizio
De Lorenzis, Elisa
Albo, Giancarlo
Salonia, Andrea
Montanari, Emanuele
Boeri, Luca
author_sort Pozzi, Efrem
collection PubMed
description Background: Scoring metrics to assess and compare outcomes of percutaneous nephrolithotomy (PCNL) are needed. We aim to evaluate prevalence and predictors of trifecta in a cohort of patients treated with vacuum-assisted mini-percutaneous nephrolithotomy (vmPCNL) for kidney stones. Methods: Data from 287 participants who underwent vmPCNL were analysed. Patients’ and stones’ characteristics as well as operative data were collected. Stone-free was defined as no residual stones. The modified Clavien classification was used to score postoperative complications. Trifecta was defined as stone-free status without complications after a single session and no auxiliary procedures. Descriptive statistics and logistic regression models tested the association between predictors and trifecta outcome. Results: After vmPCNL, 219 (76.3%) patients were stone-free, and 81 (28.2%) had postoperative complications (any Clavien). Of 287, 170 (59.2%) patients achieved trifecta criteria. Patients who achieved trifecta status had smaller stone volume (p < 0.001), a higher rate of single stones (p < 0.001), shorter operative time (p < 0.01), and a higher rate of single percutaneous tract (p < 0.01) than −trifecta patients. Trifecta status decreased with the number of calyces involved, being 77.1%, 18.8%, and 4.1% in patients with 1, 2, or 3 calyces with stones, respectively (p < 0.001). Multivariable logistic regression analysis showed that stone volume (OR 1.1, p = 0.02) and multiple calyces being involved (OR 2.8 and OR 4.3 for two- and three-calyceal groups, respectively, all p < 0.01) were independent unfavourable risk factors for trifecta after accounting for age, BMI, gender, operative time, and number of access tracts. Conclusions: Trifecta status was achieved in 6 out of 10 patients after vmPCNL. Stone distribution in multiple calyceal groups and stone volume were independent unfavourable risk factors for trifecta.
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spelling pubmed-96979322022-11-26 Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience Pozzi, Efrem Malfatto, Matteo Turetti, Matteo Silvani, Carlo Jannello, Letizia Maria Ippolita Garbagnati, Susanna Galbiati, Gilda Zanetti, Stefano Paolo Longo, Fabrizio De Lorenzis, Elisa Albo, Giancarlo Salonia, Andrea Montanari, Emanuele Boeri, Luca J Clin Med Article Background: Scoring metrics to assess and compare outcomes of percutaneous nephrolithotomy (PCNL) are needed. We aim to evaluate prevalence and predictors of trifecta in a cohort of patients treated with vacuum-assisted mini-percutaneous nephrolithotomy (vmPCNL) for kidney stones. Methods: Data from 287 participants who underwent vmPCNL were analysed. Patients’ and stones’ characteristics as well as operative data were collected. Stone-free was defined as no residual stones. The modified Clavien classification was used to score postoperative complications. Trifecta was defined as stone-free status without complications after a single session and no auxiliary procedures. Descriptive statistics and logistic regression models tested the association between predictors and trifecta outcome. Results: After vmPCNL, 219 (76.3%) patients were stone-free, and 81 (28.2%) had postoperative complications (any Clavien). Of 287, 170 (59.2%) patients achieved trifecta criteria. Patients who achieved trifecta status had smaller stone volume (p < 0.001), a higher rate of single stones (p < 0.001), shorter operative time (p < 0.01), and a higher rate of single percutaneous tract (p < 0.01) than −trifecta patients. Trifecta status decreased with the number of calyces involved, being 77.1%, 18.8%, and 4.1% in patients with 1, 2, or 3 calyces with stones, respectively (p < 0.001). Multivariable logistic regression analysis showed that stone volume (OR 1.1, p = 0.02) and multiple calyces being involved (OR 2.8 and OR 4.3 for two- and three-calyceal groups, respectively, all p < 0.01) were independent unfavourable risk factors for trifecta after accounting for age, BMI, gender, operative time, and number of access tracts. Conclusions: Trifecta status was achieved in 6 out of 10 patients after vmPCNL. Stone distribution in multiple calyceal groups and stone volume were independent unfavourable risk factors for trifecta. MDPI 2022-11-16 /pmc/articles/PMC9697932/ /pubmed/36431265 http://dx.doi.org/10.3390/jcm11226788 Text en © 2022 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
Pozzi, Efrem
Malfatto, Matteo
Turetti, Matteo
Silvani, Carlo
Jannello, Letizia Maria Ippolita
Garbagnati, Susanna
Galbiati, Gilda
Zanetti, Stefano Paolo
Longo, Fabrizio
De Lorenzis, Elisa
Albo, Giancarlo
Salonia, Andrea
Montanari, Emanuele
Boeri, Luca
Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience
title Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience
title_full Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience
title_fullStr Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience
title_full_unstemmed Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience
title_short Validation of the Trifecta Scoring Metric in Vacuum-Assisted Mini-Percutaneous Nephrolithotomy: A Single-Center Experience
title_sort validation of the trifecta scoring metric in vacuum-assisted mini-percutaneous nephrolithotomy: a single-center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9697932/
https://www.ncbi.nlm.nih.gov/pubmed/36431265
http://dx.doi.org/10.3390/jcm11226788
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