G.E.S.S.O.nephrolithometry:Novel Kidney Calculi Classification System For Minimally Invasive Percutaneous Nephrolithotomy

Objective To explore the establishment of G.E.S.S.O.nephrolithometry scoring system and investigate the clinical value of G.E.S.S.O.scoring system for minimally invasive percutaneous nephrolithotomy(mPCNL).Methods A literature review was performed to identify reproduCIble variables that could affect the outcomes of mPCNL and build G.E.S.S.O.scoring system.Five reproduCIble variables available from non-contrast-enhanced computed to mograohy were measured,including Guy ’s stone grading(G),essence or stone density(E),massive accumulative stone size(S),body weight index or scale(S),and obstruction(O),which was named G.E.S.S.O.nephrolithometry scoring system.A retrospective analysis was conducted by collecting clinical data of 142 patients with undergoing mPCNL from April 2015 to June 2016.According to the preoperative urinary CTU image,variables that affecting the stone clearance rate were measured.The correlation of scores based on G.E.S.S.O.Score with stone clearance,operation time,blood loss,postoperative hospital stay and postoperative complications were analyzed.Result This study included totally 142 patients with kidney stones undergoing mPCNL.The stone clearance rate was 69.7%(99/142).The postoperative complications occurred in 41(28.9%)cases.The G.E.S.S.O.score was 6.77±1.276 with stone free,which was extremely lower the score 9.60±1.892 with residual stones(t =-8.986,P = 0.000).G.E.S.S.O.scoring system has showed significant correlation with the stone free status,postoperative complications and operating time(P<0.01),but it didn’t have correlation with intraoperative blood loss(P=0.112),severity of complications(P>0.05).G.E.S.S.O.score area under the r curve of ROC curves was 0.888(95% CI 0.828-0.948).Conclusion G.E.S.S.O.scoring system can accurately predict the rate of free stone undergoing mPCNL and have the ability to understand disease related assessment.With regard to the intraoperative blood loss,perioperative period situation,larger sample,multicenter,randomized,prospective studies are needed to judge the value of the score.