Articles Vol. 67 No. 7 26/07/2026

THE ROLE OF GUY'S STONE SCORE IN MINI-PERCUTANEOUS NEPHROLITHOTOMY

Nguyen Ngoc Thai1,2,3,4, Ngo Xuan Thai1,3, Nguyen Huynh Dang Khoa1,3, Tran Thanh Tung5,6
1 Department of Urology, School of Medicine - University of Medicine and Pharmacy at Ho Chi Minh City
2 Binh Dan Hospital
3 Bộ môn Tiết niệu học, Trường Y - Đại học Y Dược Thành phố Hồ Chí Minh
4 Bệnh viện Bình Dân
5 School of Medicine and Pharmacy, Tra Vinh University
6 Trường Y Dược, Đại học Trà Vinh
DOI: 10.52163/yhc.v67i7.5900
25 Views
0 Downloads
Keywords
Renal calculi, Mini-PCNL, Guy’s Stone Score, Stone-free rate.
Abstract

Background: Mini-percutaneous nephrolithotomy (Mini-PCNL) has emerged as a cornerstone in the minimally invasive management of renal calculi. This research aims to validate the clinical utility of the Guy’s Stone Score (GSS) as a preoperative tool for predicting surgical outcomes and potential complications in patients undergoing Mini-PCNL. Methods: A descriptive cross-sectional analysis was performed on 416 patients with renal stones who were treated via single-tract Mini-PCNL under C-arm fluoroscopic guidance at Binh Dan Hospital from January to June 2025. Stone complexity was stratified from GSS I to GSS IV based on preoperative computed tomography (CT) findings. Results: The overall stone-free rate was 83,9%. A significant downward trend in SFR was observed as the GSS increased: 93,3% for GSS I, 89,7% for GSS II, 79,0% for GSS III, and 69,8% for GSS IV (p < 0,001). The overall complication rate was 15,4%,  Guy’s stone score was not significantly associated with complication rates. Conclusions: The Guy’s Stone Score is a simple and effective tool for predicting stone-free rates in Mini-PCNL.

References
[1]
Marshall L. Urinary Stone Disease. In: McAninch JW, Lue TF, eds. Smith & Tanagho’s General Urology. 19th ed. McGraw Hill; 2020. Accessed July 30, 2025. accessmedicine.mhmedical.com/content.aspx?aid=1171179946 Google Scholar
[2]
Skolarikos A, Neisius A, Petrik A, et al. EAU Guidelines on Urolithiasis. European Association of Urology. Published online March 2023. https://uroweb.org/ guidelines/ urolithiasis. Google Scholar
[3]
David A, Jean J, David M. Strategies for Nonmedical Management of Upper Urinary Tract Calculi. In: Alan W, Roger R, Louis R, Craig A, eds. Campbell-Walsh-Wein Urology. 12th ed. Elsevier; 2021:2069-2093. Google Scholar
[4]
Kim CH, Chung DY, Rha KH, et al. Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis. Medicina. 2021;57(1):1. doi:10.3390/ medicina57010026 Google Scholar
[5]
Borofsky MS, Wollin DA, Reddy T, et al. Salvage Percutaneous Nephrolithotomy: Analysis of Outcomes following Initial Treatment Failure. J Urol. 2016;195(4 Pt 1):977-981. doi:10.10 16/j.juro.2015.10.176 Google Scholar
[6]
Moeen AM, Basir SMA, Zarzour MA, et al. Predictors of salvage percutaneous nephrolithotomy: experience in 752 patients. The Egyptian Journal of Surgery. 2023;42(1). doi:10.4103/ejs.ejs_42_23 Google Scholar
[7]
Yoon HS, Song W, Kim KH, et al. Ambulatory second look percutaneous nephrolithotripsy with maturated nephros-tomy tract. Int Braz J Urol. 2020;46(4):676. doi:10.1590/S1677-5538.IBJU.2019.0003 Google Scholar
[8]
Okhunov Z, Friedlander JI, George AK, et al. S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology. 2013;81(6):1154-1159. doi:10.1016/j. urology.2012.10.083 Google Scholar
[9]
Thomas K, Smith NC, Hegarty N, et al. The Guy’s stone score-grading the complexity of percutaneous nephrolithotomy procedures. Urology. 2011;78(2):277-281. doi:10.10 16/j. urology.2010.12.026 Google Scholar
[10]
Smith A, Averch TD, Shahrour K, et al. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol. 2013;190(1):149-156. doi:10.1016/j.juro.2013.01.047 Google Scholar
[11]
Assimos D, Krambeck A, Miller NL, et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol. 2016; 196 (4):11 61-1169. doi:10.1016/j.juro.2016.05.091 Google Scholar
[12]
Kiều Đức Vinh, Nguyễn Việt Hải, Trần Đức Dũng, et al. Đánh giá kết quả lấy sỏi thận qua da đường hầm nhỏ theo thang điểm GUY. Journal of 108 - Clinical Medicine and Phamarcy. Published online June 3, 2024. doi:10.52389/ydls.v19incs.2364 Google Scholar
[13]
De La Rosette JJ, Opondo D, Daels FP, et al. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012;62 (2):246-255. doi:10.1016/j.eururo.2012.03.055 Google Scholar
[14]
Vicentini FC, Marchini GS, Mazzucchi E, et al. Utility of the Guy’s stone score based on computed tomographic scan findings for predicting percutaneous nephrolithotomy outcomes. Urology. 2014;83(6):1248-1253. doi:10.1016/j.urology.2013.12.041 Google Scholar