Abstract
Purpose: To evaluate the applicability of contemporary percutaneous nephrolithotomy (PCNL) scoring systems in pediatric patients and to compare their predictive power for postoperative outcomes. Materials and methods: The records of 125 pediatric patients who were diagnosed with renal calculi and managed with PCNL between March 2011 and April 2016 were retrospectively analyzed. The predictive scoring systems; The Guy’s Stone Score (GSS), S.T.O.N.E. nephrolithometry and, Clinical Research Office of the Endourological Society (CROES) were calculated for all patients included in the study. Patient demographics, stone free rate (SFR), and complications were all reported and analyzed. Results: In patients with residual stones (group I) vs those who were (group II) stone free the median (IQR) of GSS was 2 (2-3) and 2 (1-2), CROES nomogram score was 215 (210-235) and 257 (240-264), and S.T.O.N.E. nephrolithometry score was 8 (7-9) and 5 (5-6), respectively (each <p0.0001). S.T.O.N.E. nephrolithometry score revealed the highest accuracy in predicting SFR. GSS was significantly correlated with complications but the CROES nomogram and S.T.O.N.E nephrolithometry were not significantly correlated with complications. Conclusion: The scoring systems could be used in predicting PCNL success in pediatric setting. However, further studies are required to make modifications in the scoring systems in pediatrics. The main variables in the scoring systems as stone burden, tract length and case volume were measured using records from adult patients. Besides these variables, the relatively small pelvicalyceal system and the higher incidence of anatomic malformations in pediatrics could potentially affect PCNL outcomes.