Cargando…
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...
Autores principales: | , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1784838691033710592 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9697932 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT pozziefrem validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT malfattomatteo validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT turettimatteo validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT silvanicarlo validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT jannelloletiziamariaippolita validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT garbagnatisusanna validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT galbiatigilda validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT zanettistefanopaolo validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT longofabrizio validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT delorenziselisa validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT albogiancarlo validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT saloniaandrea validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT montanariemanuele validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience AT boeriluca validationofthetrifectascoringmetricinvacuumassistedminipercutaneousnephrolithotomyasinglecenterexperience |