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The Mayo adhesive probability score predicts postoperative fever and intraoperative hemorrhage in mini-percutaneous nephrolithotomy

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Abstract

Purpose

Contemporary predictive tools for miniaturized percutaneous nephrolithotomy (mPCNL) mainly focus on stone clearance but not perioperative complications, especially infection and hemorrhage. This study aimed to evaluate whether the Mayo adhesive probability (MAP) score, an index of the perinephric fat characteristics, can predict postoperative fever and intraoperative hemorrhage in mPCNL.

Methods

This is a retrospective study recruiting 159 mPCNL patients from July 2018 to January 2022. MAP scores were recorded using preoperative computed tomography. Postoperative complications included postoperative fever and intraoperative bleeding, defined as hemoglobin drop.

Results

Over half patients had the MAP score ≧ 3. Men, elderly, chronic kidney disease, and diabetes were associated with a higher MAP score. The patients with a higher MAP score were more likely to have postoperative fever after mPCNL. On multivariate analysis, preoperative positive urine culture (OR 2.68) and a higher MAP score (OR 2.28) were both significantly associated with postoperative fever. ROC curves analysis of the combination of these two factors on predicting postoperative fever showed AUC values were 0.731 (0.652–0.810). Moreover, a higher MAP score (OR 2.30) and longer operative time (OR 2.16) were significantly associated with higher hemoglobin drop on multivariate analysis.

Conclusion

A high MAP score was associated with postoperative fever and intraoperative hemorrhage in patients undergoing mPCNL. The MAP score can be a novel and easy predictive tool to help endourologists improve the awareness of mPCNL safety.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Assimos D, Krambeck A, Miller NL, Monga M, Murad MH, Nelson CP, Pace KT, Pais VM Jr, Pearle MS, Preminger GM, Razvi H, Shah O, Matlaga BR (2016) Surgical management of stones: american urological association/endourological society guideline, PART II. J Urol 196:1161–1169. https://doi.org/10.1016/j.juro.2016.05.091

    Article  PubMed  Google Scholar 

  2. Wright A, Rukin N, Smith D, De la Rosette J, Somani BK (2016) “Mini, ultra, micro” - nomenclature and cost of these new minimally invasive percutaneous nephrolithotomy (PCNL) techniques. Ther Adv Urol 8:142–146. https://doi.org/10.1177/1756287215617674

    Article  PubMed  Google Scholar 

  3. Taguchi K, Cho SY, Ng AC, Usawachintachit M, Tan YK, Deng YL, Shen CH, Gyawali P, Alenezi H, Basiri A, Bou S, Djojodemedjo T, Sarica K, Shi L, Singam P, Singh SK, Yasui T (2019) The urological association of asia clinical guideline for urinary stone disease. Int J Urol 26:688–709. https://doi.org/10.1111/iju.13957

    Article  PubMed  Google Scholar 

  4. Lu ZH, Lin TY, Huang HS, Liu CJ (2021) Preoperative urine analysis is an effective tool to predict fever after miniaturized percutaneous nephrolithotomy on large renal stones. Urol J 18:600–607. https://doi.org/10.22037/uj.v18i.6463

    Article  PubMed  Google Scholar 

  5. Veccia A, Antonelli A, Uzzo RG, Novara G, Kutikov A, Ficarra V, Simeone C, Mirone V, Hampton LJ, Derweesh I, Porpiglia F, Autorino R (2020) Predictive value of nephrometry scores in nephron-sparing surgery: a systematic review and meta-analysis. Eur Urol Focus 6:490–504. https://doi.org/10.1016/j.euf.2019.11.004

    Article  PubMed  Google Scholar 

  6. Thiel DD, Davidiuk AJ, Meschia C, Serie D, Custer K, Petrou SP, Parker AS (2016) Mayo adhesive probability score is associated with localized renal cell carcinoma progression-free survival. Urology 89:54–60. https://doi.org/10.1016/j.urology.2015.10.034

    Article  PubMed  Google Scholar 

  7. Demirelli E, Ogreden E, Bayraktar C, Tosun A, Oguz U (2022) The effect of perirenal fat stranding on infectious complications after ureterorenoscopy in patients with ureteral calculi. Asian J Urol 9:307–312. https://doi.org/10.1016/j.ajur.2021.11.006

    Article  PubMed  Google Scholar 

  8. Khene ZE, Peyronnet B, Mathieu R, Fardoun T, Verhoest G, Bensalah K (2015) Analysis of the impact of adherent perirenal fat on peri-operative outcomes of robotic partial nephrectomy. World J Urol 33:1801–1806. https://doi.org/10.1007/s00345-015-1500-0

    Article  PubMed  Google Scholar 

  9. Thomas K, Smith NC, Hegarty N, Glass JM (2011) The Guy’s stone score–grading the complexity of percutaneous nephrolithotomy procedures. Urology 78:277–281. https://doi.org/10.1016/j.urology.2010.12.026

    Article  PubMed  Google Scholar 

  10. Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, Hillelsohn J, Smith AD, Okeke Z (2013) S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology 81:1154–1159. https://doi.org/10.1016/j.urology.2012.10.083

    Article  PubMed  Google Scholar 

  11. Smith A, Averch TD, Shahrour K, Opondo D, Daels FP, Labate G, Turna B, de la Rosette JJ, Group CPS (2013) A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol 190:149–156. https://doi.org/10.1016/j.juro.2013.01.047

    Article  PubMed  Google Scholar 

  12. Shahat AA, Abonnoor AEI, Allaham SMT, Abdel-Moneim AM, El-Anany FG, Abdelkawi IF (2020) Critical application of adult nephrolithometric scoring systems to children undergoing mini-percutaneous nephrolithotomy. J Endourol 34:924–931. https://doi.org/10.1089/end.2020.0281

    Article  PubMed  Google Scholar 

  13. Mazzon G, Claps F, Pavan N, Choong S, Zeng G, Wu W, Zhong J, Bada M, Pirozzi M, Vitale R, Celia A (2023) Reliability of nephrolithometric nomograms in patients treated with minimally invasive percutaneous nephrolithotomy: a precision study. Asian J Urol 10:70–80. https://doi.org/10.1016/j.ajur.2022.02.010

    Article  PubMed  Google Scholar 

  14. Chen D, Jiang C, Liang X, Zhong F, Huang J, Lin Y, Zhao Z, Duan X, Zeng G, Wu W (2019) Early and rapid prediction of postoperative infections following percutaneous nephrolithotomy in patients with complex kidney stones. BJU Int 123:1041–1047. https://doi.org/10.1111/bju.14484

    Article  CAS  PubMed  Google Scholar 

  15. Guler A, Erbin A, Ucpinar B, Savun M, Sarilar O, Akbulut MF (2019) Comparison of miniaturized percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for the treatment of large kidney stones: a randomized prospective study. Urolithiasis 47:289–295. https://doi.org/10.1007/s00240-018-1061-y

    Article  CAS  PubMed  Google Scholar 

  16. Chew BH, Miller NL, Abbott JE, Lange D, Humphreys MR, Pais VM Jr, Monga M, Krambeck AE, Sur RL (2018) A randomized controlled trial of preoperative prophylactic antibiotics prior to percutaneous nephrolithotomy in a low infectious risk population: a report from the EDGE consortium. J Urol 200:801–808. https://doi.org/10.1016/j.juro.2018.04.062

    Article  CAS  PubMed  Google Scholar 

  17. Qin P, Zhang D, Huang T, Fang L, Cheng Y (2022) Comparison of mini percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for renal stones >2cm: a systematic review and meta-analysis. Int Braz J Urol 48:637–648. https://doi.org/10.1590/S1677-5538.IBJU.2021.0347

    Article  PubMed  Google Scholar 

  18. Wang S, Yuan P, Peng E, Xia D, Xu H, Wang S, Ye Z, Chen Z (2020) Risk factors for urosepsis after minimally invasive percutaneous nephrolithotomy in patients with preoperative urinary tract infection. Biomed Res Int 2020:1354672. https://doi.org/10.1155/2020/1354672

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Lai WS, Assimos D (2018) Factors associated with postoperative infection after percutaneous nephrolithotomy. Rev Urol 20:7–11. https://doi.org/10.3909/riu0778

    Article  PubMed  PubMed Central  Google Scholar 

  20. Smith RC, Verga M, Dalrymple N, McCarthy S, Rosenfield AT (1996) Acute ureteral obstruction: value of secondary signs of helical unenhanced CT. AJR Am J Roentgenol 167:1109–1113. https://doi.org/10.2214/ajr.167.5.8911160

    Article  CAS  PubMed  Google Scholar 

  21. Kim JW, Lee YJ, Ha YS, Lee JN, Kim HT, Chun SY, Kim BS (2020) Secondary signs on preoperative CT as predictive factors for febrile urinary tract infection after ureteroscopic lithotripsy. BMC Urol 20:131. https://doi.org/10.1186/s12894-020-00701-7

    Article  PubMed  PubMed Central  Google Scholar 

  22. Akman T, Binbay M, Sari E, Yuruk E, Tepeler A, Akcay M, Muslumanoglu AY, Tefekli A (2011) Factors affecting bleeding during percutaneous nephrolithotomy: single surgeon experience. J Endourol 25:327–333. https://doi.org/10.1089/end.2010.0302

    Article  PubMed  Google Scholar 

  23. Macleod LC, Hsi RS, Gore JL, Wright JL, Harper JD (2014) Perinephric fat thickness is an independent predictor of operative complexity during robot-assisted partial nephrectomy. J Endourol 28:587–591. https://doi.org/10.1089/end.2013.0647

    Article  PubMed  Google Scholar 

  24. Srivastava A, Yadav P, Madhavan K, Sureka SK, Singh UP, Kapoor R, Ansari MS, Lal H, Mishra P (2019) Inter-observer variability amongst surgeons and radiologists in assessment of Guy’s Stone Score and S.T.O.N.E. nephrolithometry score: a prospective evaluation. Arab J Urol 18:118–123. https://doi.org/10.1080/2090598X.2019.1703278

    Article  PubMed  PubMed Central  Google Scholar 

  25. Al Adl AM, Mohey A, Abdel Aal A, Abu-Elnasr HAF, El Karamany T, Noureldin YA (2020) Percutaneous nephrolithotomy outcomes based on S.T.O.N.E., GUY, CROES, and S-ReSC scoring systems: the first prospective study. J Endourol 34:1223–1228. https://doi.org/10.1089/end.2019.0856

    Article  PubMed  Google Scholar 

  26. Noureldin YA, Elkoushy MA, Andonian S (2015) Which is better? Guy’s versus S.T.O.N.E. nephrolithometry scoring systems in predicting stone-free status post-percutaneous nephrolithotomy. World J Urol 33:1821–1825. https://doi.org/10.1007/s00345-015-1508-5

    Article  PubMed  Google Scholar 

  27. Vernez SL, Okhunov Z, Motamedinia P, Bird V, Okeke Z, Smith A (2016) Nephrolithometric scoring systems to predict outcomes of percutaneous nephrolithotomy. rev Urol 18:15–27

    PubMed  PubMed Central  Google Scholar 

  28. Biswas K, Gupta SK, Tak GR, Ganpule AP, Sabnis RB, Desai MR (2020) Comparison of STONE score, Guy’s stone score and Clinical Research Office of the Endourological Society (CROES) score as predictive tools for percutaneous nephrolithotomy outcome: a prospective study. BJU Int 126:494–501. https://doi.org/10.1111/bju.15130

    Article  PubMed  Google Scholar 

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Funding

The research did not receive any specific grant from funding agencies in the public or commercial.

Author information

Authors and Affiliations

  1. School of Medicine, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan

    Wei-An Chen

  2. Department of Urology, College of Medicine, National Cheng Kung University, Tainan, 704302, Taiwan

    Ho-Shiang Huang, Ze-Hong Lu & Chan-Jung Liu

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Contributions

WAC: investigation, data collection and management, data analysis, manuscript writing—original draft. HSH: data management. ZHL: data collection and management. CJL: conceptualization; data collection and management; investigation; data analysis; project development; resources; supervision; visualization; manuscript writing—original draft; manuscript writing—review and editing.

Corresponding author

Correspondence to Chan-Jung Liu.

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Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

Ethical approval was waived by the local Ethics Committee (IRB number: A-ER-107-291 and A-ER-108-425) in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Approval of the research protocol by an institutional reviewer board and the approval number

Approved by National Cheng Kung University Hospital Institutional Ethics Committee (IRB number: A-ER-107-291 and A-ER-108-425). The requirement for written Informed Consent was waived by the approving ethics committee as this was a retrospective study.

Informed consent

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Chen, WA., Huang, HS., Lu, ZH. et al. The Mayo adhesive probability score predicts postoperative fever and intraoperative hemorrhage in mini-percutaneous nephrolithotomy. World J Urol 41, 2503–2509 (2023). https://doi.org/10.1007/s00345-023-04529-2

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  • DOI: https://doi.org/10.1007/s00345-023-04529-2

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