Validation of the Trifecta Scoring Metric in Vacuum-AssistedùMini-Percutaneous Nephrolithotomy: ASingle-Center Experience
Articolo
Data di Pubblicazione:
2022
Citazione:
Validation of the Trifecta Scoring Metric in Vacuum-AssistedùMini-Percutaneous Nephrolithotomy: ASingle-Center Experience / E. Pozzi, M. Malfatto, M. Turetti, C. Silvani, L.M.I. Jannello, S. Garbagnati, G. Galbiati, S.P. Zanetti, F. Longo, E. De Lorenzis, G. Albo, A. Salonia, E. Montanari, L. Boeri. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 11:(2022 Nov), pp. 6788.1-6788.9. [10.3390/jcm11226788]
Abstract:
Background: Scoring metrics to assess and compare outcomes of percutaneous nephro-
lithotomy (PCNL) are needed. We aim to evaluate prevalence and predictors of trifecta in a cohort
of patients treated with vacuum-assisted mini-percutaneous nephrolithotomy (vmPCNL) for kid-
ney stones. Methods: Data from 287 participants who underwent vmPCNL were analysed. Patients’
and stones’ characteristics as well as operative data were collected. Stone-free was defined as no
residual stones. The modified Clavien classification was used to score postoperative complications.
Trifecta was defined as stone-free status without complications after a single session and no auxil-
iary procedures. Descriptive statistics and logistic regression models tested the association between
predictors and trifecta outcome. Results: After vmPCNL, 219 (76.3%) patients were stone-free, and
81 (28.2%) had postoperative complications (any Clavien). Of 287, 170 (59.2%) patients achieved
trifecta criteria. Patients who achieved trifecta status had smaller stone volume (p < 0.001), a higher
rate of single stones (p < 0.001), shorter operative time (p < 0.01), and a higher rate of single percuta-
neous tract (p < 0.01) than −trifecta patients. Trifecta status decreased with the number of calyces
involved, being 77.1%, 18.8%, and 4.1% in patients with 1, 2, or 3 calyces with stones, respectively
(p < 0.001). Multivariable logistic regression analysis showed that stone volume (OR 1.1, p = 0.02)
and multiple calyces being involved (OR 2.8 and OR 4.3 for two- and three-calyceal groups, respec-
tively, all p < 0.01) were independent unfavourable risk factors for trifecta after accounting for age,
BMI, gender, operative time, and number of access tracts. Conclusions: Trifecta status was achieved
in 6 out of 10 patients after vmPCNL. Stone distribution in multiple calyceal groups and stone vol-
ume were independent unfavourable risk factors for trifecta.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
percutaneous nephrolithotomy; vacuum-assisted percutaneous nephrolithotomy; stone-free rate; complications; trifecta
Elenco autori:
E. Pozzi, M. Malfatto, M. Turetti, C. Silvani, L.M.I. Jannello, S. Garbagnati, G. Galbiati, S.P. Zanetti, F. Longo, E. De Lorenzis, G. Albo, A. Salonia, E. Montanari, L. Boeri
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