Application Of Modified RUSS Renal Stone Scoring System In Predicting The Stone Free Rate In Flexible Ureteroscopic Lithotripsy(FURL)

ObjectiveTo establish a new renal stone scoring system for predicting the stone free rate after flexible ureteroscopic lithotripsyMaterials and methodsA retrospective analysis patients with renal stone who underwent flexible ureteroscopic lithotripsy(FURL)in the Second Affiliated Hospital of Zhengzhou University from March 2017 to January 2019 was performed.After screening,104 patients were included in the study,and the stone free rate and related influencing factors were counted.The patient's clinical data were scored using the RUSS renal stone scoring system to verify the reliability of the RUSS kidney stone scoring system.The RUSS renal stone scoring system was supplemented and improved by factors affecting the stone free rate after FURL.The modified RUSS renal stone scoring system was used to re-score the patient's clinical datas,and to test the accuracy of predicting the stone rate after FURL.To compare the accuracy between the two renal stone scoring systems in predicting the stone free rate after FURL by drawing the ROC curve.Statistical analysis and clinical application were performed according to the modified RUSS renal stone score.Results? FURL was successfully performed in 104 patients without serious postoperative complications.The stone free rate was 69.23%(72/104).? The results of this study showed that the renal anatomical structure,multiple stones,stone size grading,stone area,stone accumulated number of calyces,CT value,stone under the calyces,staghorn stones,IPA were related factors affecting the stone free rate after FURL.Among them,multiple stones,stone size grading,stone area,and stone accumulative number of calyces and IPA were independent risk factors.? Both the original RUSS and the modified RUSS renal stone scoring system were significantly correlated with the stone free rate after FURL(P<0.05).The area under the ROC curve(AUC: 0.865)of the modified RUSS renal stone scoring system was larger than that of the original RUSS scoring system(AUC: 0.707).? The score range of the modified RUSS renal stone scoring system in this study was between 0-4 points,among which the stone free rates of patients with 0,1,2,3 and 4 points were 100%,92.31%,54.17%,47.37% and 10.00%,respectively.The stone score were all significantly correlated with the stone free rate(P < 0.05).ConclusionThe modified RUSS renal stone scoring system can accurately predict the stone free rate after FURL,with simple operation and strong practicability.It can not only help patients to consult,but it also assist doctors to make surgical plans and conduct academic exchanges,which has important clinical significance.