Does the presence of a percutaneous renal access influence fluoroscopy time during percutaneous nephrolithotomy?
Why this work is in the frame
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Bibliographic record
Abstract
The aim of this study was to assess whether the presence of a pre-formed percutaneous renal access (PCA) had any effects on fluoroscopy time (FT) during percutaneous nephrolithotomy (PCNL). After ethics approval was obtained, medical records of all patients who underwent PCNL between 2009 and 2013 at a tertiary stone referral centre were retrospectively reviewed. Patients with and without pre-formed PCA undergoing PCNL were compared. Patients who underwent second-look PCNL and those who had their access inserted by interventional radiology constituted the group with pre-formed PCA. A total of 185 PCNLs were reviewed. The mean patient age was 55.2 ± 1.0 years with mean body mass index (BMI) of 27.8 ± 0.5 kg/m2 and male gender of 63.8%. The mean stone size was 618.4 ± 47.0 mm2 with mean Guy's grade of 2.3 ± 0.7 and mean S.T.O.N.E. score of 7.6 ± 0.1. The mean operative time was 98.7 ± 2.6 min with mean FT of 113.4 ± 4.5 s. The overall stone-free rate was 71.9% with complication rate of 16.2%. When compared with PCNLs without pre-formed PCA, PCNLs with pre-formed PCA were associated with significantly shorter FT (120.6 ± 5.1 vs. 77.5 ± 6.7 s; p < 0.001) and significantly lower estimated blood loss (EBL) (p = 0.01). On multivariate analysis, PCNLs with pre-formed PCA were associated with significantly shorter FT (B. coefficient = −43.2 (95%CI: −66.4 to −20); p < 0.001) and lower EBL (p = 0.02). PCNLs with pre-formed PCA were associated with significantly lower FT and EBL when compared with PCNLs without pre-formed PCA.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it