Relation between Guy‘s Stone Score (GSS) with Minor Complications according to Clavien Grading Score and Duration Time of PCNL Procedure at Adam Malik Central General Hospital Medan

Boni Irawan; Dhirajaya Dharma Khadar; Syah Mirsya Warli

Volume : VIII, Issue : VIII, August - 2018

Relation between Guy‘s Stone Score (GSS) with Minor Complications according to Clavien Grading Score and Duration Time of PCNL Procedure at Adam Malik Central General Hospital Medan

Boni Irawan, Dhirajaya Dharma Khadar, Syah Mirsya Warli

Abstract :

Introduction Percutaneous Nephrolithotomy (PCNL) is one of the minimally invasive in urology aimed at removing kidney stones using percutaneous access to reach the pelviocalises system. One of the simplest and applicative scoring systems as a predictor of PCNL procedures is Guy‘s Stone Score. The emergence of complications due to PCNL procedure is grouped into several categories as Clavien Grading Score and is significantly more frequent in patients with higher GSS scores. The purpose of this study was to investigate the relationship between Guy‘s Stone Score (GSS) with minor complications according to Clavien Grading Score and duration of operation on PCNL surgery procedure at RSUP H. Adam Malik Medan. Methods This research is an analytical study with retrospective design. During the period of April to May 2018, 50 patients underwent the PCNL procedures, aged> 18 years, and with complete examination data were included in the study. Patients who have performed ESWL and endorology before PCNL procedures did not participate in the study. The variables in this study are numerical variables consisting of Guy‘s Stone Score (GSS), minor complications based on Clavien Grading Score and duration of operation. Data analysis was then conducted to assess the correlation between GSS with minor complications based on Clavien Grading Score and to assess GSS with duration of operation using Spearman Rho correlation test. Results Of the 50 patients who underwent PCNL procedure, 27 (54%) of men were found, mean age 52.06 ± 9.69 years, ASA 1 group was mostly found in 44 (88%) patients, group GSS 4 was 23 (46%) patients, 37 (74%) patients had minor complications based on Clevien Grading Score, 46 (92%) of patients did not have postoperative fever with mean treatment duration of 7.16 ± 4.15 days. The average of Guy‘s Stone Score in this patient was 3.18 ± 0.91, the mean duration of surgery in all patients was 167 ± 23.56 min, the mean preoperative and postoperative Hb rates were 11.84 ± 1.92 and 10 , 80 ± 1.87 gram / dl. Spearman Rho correlation test between GSS and duration of operation showed significant relationship (r = 0,8; p <0,001). Spearman Rho correlation test to assess the relationship between GSS with minor complications according to Clavien Grading Score showed there was no significant relationship (r = 0.6, p = 0.40). Conclusion From the 50 subjects who underwent PCNL surgery, 23 (46%) patients had GSS IV scores with a mean GSS score of 3.18 ± 0.9 and minor complications according to Clavien Grading Score of 37 (74%) patients with an average duration of surgery 167 ± 23.56 minutes. Hypothesis test in this study using Spearman Rho correlation test to see the relationship between GSS with long operation showed significant relationship (p <0.001) with moderate correlation strength (r = 0.6).