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Original Research 


CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital

Intan Andaru, Wahjoe Djatisoesanto, Tetuka Bagus Laksita, Muhammad Hidayat S. Atmaja, Agustin J. Nanda De Niro, Mohamad Reza Affandi.


Abstract
Objective: To compare computed tomography (CT) stone volume and Guy’s Stone Score (GSS) as pre operative predictors of stone free rate (SFR) and early (≤30 day) complications after single tract percutaneous nephrolithotomy (PCNL).
Methods: This prospective, analytic observational study was conducted at Dr Soetomo General Hospital, Surabaya, Indonesia, between 1 March 2024 and 30 June 2025. It included 82 adult patients who underwent single tract PCNL. Stone volume was calculated by ellipsoid formula on Synapse 3D®, anatomical complexity was assessed by GSS I-IV, while the primary outcome was stone-free rate (SFR) and secondary outcome was early complications (PCNL-specific Clavien-Dindo). Mann-Whitney U, χ², and Spearman correlation were used for data analysis.
Results: Sixty one patients achieved SFR (74 %). Median stone volume was 4.91 cm³ (IQR 4.19–5.68) in stone free versus 12.03 cm³ (10.00–13.33) in non stone free cases (p < 0.001). Stone volume correlated strongly and inversely with SFR (ρ= –0.75, p<0.001). All GSS I–II cases were stone free, whereas all GSS III–IV retained fragments, yielding an even stronger inverse correlation (ρ = –0.80, p<0.001). Early complications were limited to Clavien I (18, 22 %) and II (64, 78 %); none ≥III. Complication grade correlated modestly with GSS (ρ = +0.28, p=0.011) and stone volume (ρ = +0.25, p=0.024).
Conclusion: GSS remains the most powerful single predictor of stone clearance and minor complications after single tract PCNL, whereas CT derived stone volume offers complementary quantitative nuance. Integrating both parameters may refine risk stratification and operative planning in high volume settings

Key words: percutaneous nephrolithotomy; Guy’s Stone Score; stone volume; stone free rate; Clavien–Dindo complications.


 
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How to Cite this Article
Pubmed Style

Andaru I, Djatisoesanto W, Laksita TB, Atmaja MHS, Niro AJND, Affandi MR. CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital. RMJ. 2026; 51(2): 413-417. doi:10.5455/rmj.20250827050233

Web Style

Andaru I, Djatisoesanto W, Laksita TB, Atmaja MHS, Niro AJND, Affandi MR. CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital. https://www.rmj.org.pk/?mno=279954 [Access: May 26, 2026]. doi:10.5455/rmj.20250827050233

AMA (American Medical Association) Style

Andaru I, Djatisoesanto W, Laksita TB, Atmaja MHS, Niro AJND, Affandi MR. CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital. RMJ. 2026; 51(2): 413-417. doi:10.5455/rmj.20250827050233


Vancouver/ICMJE Style

Andaru I, Djatisoesanto W, Laksita TB, Atmaja MHS, Niro AJND, Affandi MR. CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital. RMJ. (2026), [cited May 26, 2026]; 51(2): 413-417. doi:10.5455/rmj.20250827050233


Harvard Style

Andaru, I., Djatisoesanto, . W., Laksita, . T. B., Atmaja, . M. H. S., Niro, . A. J. N. D. & Affandi, . M. R. (2026) CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital. RMJ, 51 (2), 413-417. doi:10.5455/rmj.20250827050233


Turabian Style

Andaru, Intan, Wahjoe Djatisoesanto, Tetuka Bagus Laksita, Muhammad Hidayat S. Atmaja, Agustin J. Nanda De Niro, and Mohamad Reza Affandi. 2026. CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital. Rawal Medical Journal, 51 (2), 413-417. doi:10.5455/rmj.20250827050233


Chicago Style

Andaru, Intan, Wahjoe Djatisoesanto, Tetuka Bagus Laksita, Muhammad Hidayat S. Atmaja, Agustin J. Nanda De Niro, and Mohamad Reza Affandi. "CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital." Rawal Medical Journal 51 (2026), 413-417. doi:10.5455/rmj.20250827050233


MLA (The Modern Language Association) Style

Andaru, Intan, Wahjoe Djatisoesanto, Tetuka Bagus Laksita, Muhammad Hidayat S. Atmaja, Agustin J. Nanda De Niro, and Mohamad Reza Affandi. "CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital." Rawal Medical Journal 51.2 (2026), 413-417. Print. doi:10.5455/rmj.20250827050233


APA (American Psychological Association) Style

Andaru, I., Djatisoesanto, . W., Laksita, . T. B., Atmaja, . M. H. S., Niro, . A. J. N. D. & Affandi, . M. R. (2026) CT Stone Volume Versus Guy’s Stone Score for Predicting Stone Free Rate and Early Complications Following Single Tract Percutaneous Nephrolithotomy: A Prospective Cohort Study at Tertiary Hospital. Rawal Medical Journal, 51 (2), 413-417. doi:10.5455/rmj.20250827050233


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