Prospective Comparative Evaluation of STONE Score and GUY'S Score as A Pre-Operative Predictor of Stone Free Rate and Complication in PCNL Surgery

Background: PCNL remains the gold standard treatment modality for large and/or complex renal stones, because the percutaneous approach to renal stone removal is better than the open approach. Recently few scoring system is introduced aiming to predict pre-operatively the SFR and complication for better patient counselling and surgical planning ,The GUY score and STONE Nephrolithometry score are most commonly used scoring system. Here we are comparing GUYS scoring system and STONE Nephrolithometry score for pre op prediction of Stone free rate and post op complication within 30 Days Using Modified Clavien Dindo System. Methodology: This study was done as a prospective observational clinical study done on 100 patients admitted in Department of Urology, Tirunelveli medical college from February 2023 to June 2024 with urolithiasis, different scores will be given to each patient as per scoring criteria on NCCT and outcome will be measured. Patients undergoing PCNL >12 years were included. Patients who are unfit for GA, having bleeding diathesis, uncorrected coagulopathy, and pregnancy were excluded. All patients underwent routine serum, urine examinations and a NCCT scan preoperatively and Guy’s and S.T.O.N.E. score was calculated in all. Results: In our study population, at the end of 3 months, the treatment was success with absence of stones in 62 patients and in rest of patients; it was failure in 62 patients. We analysed certain parameters related to the outcome. In our study, there was no significant difference in mean age and its relation to treatment outcome. Gender of the patient also had no significant impact on outcome. Coming to stone characteristics, Failure cases had more number of stones with a mean stone number of 1.89. Mean Guys score was 2.57 in failure cases and 1.41 in treatment success cases. Similarly, when we calculated Stones score the mean score was 8.36 in failure cases and 6.93 in success cases. Similarly, complication was more in failure cases. Conclusion: Our study found that both scoring methods predicted the SFR with similar accuracy, and endourologists can utilize either score in their day-to-day work. In the outpatient department, both score systems can be quickly assigned and used to help with patient counseling. Our study’s prospective design, sufficient sample size, and rigorous application of NCCT scan to ascertain stone-free status in the post-operative phase were its strongest points.