ArticleUrolithiasis2025
Evaluating postoperative complications in standard percutaneous nephrolithotomy for renal stones larger than 2 cm: a retrospective study utilizing the E-PASS scoring system.
Article in Urolithiasis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Risk stratification of composite adverse outcomes after percutaneous nephrolithotomy based on preoperative inflammatory-nutritional status and stone complexity: a single-center retrospective study.Frontiers in nutrition · 2026Article
- The predictive utility of the E-PASS score for postoperative complications in robot-assisted partial nephrectomy: a retrospective cohort study.BMC urology · 2025Observational
- Comparative outcomes of transurethral resection of the prostate and prostate kinetic resection in treating benign prostatic hyperplasia with prostatic stones.American journal of cancer research · 2025Article
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6 authors.
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Abstract
Percutaneous nephrolithotomy (PCNL) is a widely preferred method for treating complex kidney stones, particularly in patients with larger or more complicated stones. Despite its advantages, such as minimal invasiveness and a shorter recovery time, postoperative complications can occur, thereby necessitating effective risk assessment tools to identify at-risk patients. This study evaluated the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system's utility in predicting postoperative complications following standard PCNL. This retrospective study included 218 patients who underwent standard PCNL from June 2020 to August 2024 at our institution. Data on demographics, comorbidities, and perioperative factors were collected and analyzed. Postoperative complications were classified using the modified Clavien-Dindo system. The E-PASS scoring system, which incorporates the Preoperative Risk Score (PRS), Surgical Stress Score (SSS), and Comprehensive Risk Score (CRS), was applied to stratify risk. Postoperative complications occurred in 38 patients (17.4%). Significant predictors included advanced age, higher American Society of Anesthesiologists (ASA) scores, and comorbidities like diabetes and coronary artery disease. Intraoperative factors, such as prolonged operative times, number of access and greater blood loss, were also associated with complications. Multivariate analysis identified higher CRS and greater stone burden as independent predictors (p = 0.012 and p = 0.037, respectively). The CRS demonstrated moderate discrimination, with an area under the curve (AUC) of 0.747. The E-PASS scoring system effectively predicts postoperative complications in PCNL, underscoring the importance of thorough preoperative and intraoperative evaluation. Future studies should explore its broader applicability across other urological procedures.
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