To compare the accuracy of stone scoring systems in predicting stone clearance rate (SFR) after ureteroscopic lithotripsy (RIRS) in patients with different surgical experiences.

A retrospective analysis was conducted on the clinical data of 218 patients with renal stones treated with RIRS from January 2021 to August 2022 in Affiliated Benq Hospital of Nanjing Medical University. Patients were divided into two groups ,with one group of over 50 surgeons and another of under 50 surgeons based on the experience of the surgeon. According to the scoring standards provided by various stone scoring methods, the same physician used preoperative urological CT and three-dimensional reconstruction to score the preoperative stone characteristics of two groups of patients and input data to evaluation and comparison of the accuracy of the stone scoring systems in the prediction of stone-free rate after RIRS in different surgical experience.

The total stone clearance rate of 218 cases was 68.3% (149/218). The stone clearance rate for patients who underwent more than 50 surgeries was 83.5% (111/133), while for patients who underwent less than 50 surgeries, the stone clearance rate was 44.7% (38/85). The surgical time was (20-232) min, with an average of (79±46) min. The total hospitalization time was (4-15) d, with an average of (5.2±1.8) d. The postoperative hospitalization time was (2-8) days,with an average of (3.4±1.0) d. Among them, the surgical time for more than 50 patients was (20-150) minutes, with an average of (55±24) minutes, and the surgical time for patients with less than 50 surgeries was (30-232) min, with an average of (117±48) min. There was significant difference between the two groups (P<0.05). At a certain threshold, different scoring systems have good sensitivity and specificity in predicting the postoperative stone free rate of RIRS surgery in patients with different surgical experiences. There was no significant difference in the AUC value between groups for predicting the postoperative stone free rate of RIRS in patients with different surgical experiences based on different stone scores (Z=1.695, P>0.05).

There were differences in stone clearance rate and surgical time among surgeons with different experiences after RIRS, with surgeons with more than 50 experiences having a higher stone clearance rate and shorter surgical time. S.T.O.N.E., RUSS, improved S-ReSC, R.I.R.S., SHA-LIN, Ito column chart, S.O.L.V.E., stone clearance index, T.O.HO score could accurately predict the postoperative stone clearance rate of RIRS patients with different surgical experiences. For patients with complex conditions and high predictive scores, it is recommended to have experienced surgeons perform the surgery.