Access Related Complications During Percutaneous Nephrolithotomy: Urology Versus Radiology at a Single Academic Institution
Why this work is in the frame
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Bibliographic record
Abstract
PURPOSE: A recent survey revealed that only 11% of urologists performing percutaneous nephrolithotomy routinely obtained percutaneous access themselves. Reasons for this trend may include lack of training, comfort level and perceived need for radiological involvement. In this study we evaluated percutaneous access for percutaneous nephrolithotomy obtained by interventional radiologists or a urologist at a single academic institution, and compared access trends and complications. MATERIALS AND METHODS: Two cohorts of patients who had undergone percutaneous nephrolithotomy between 1999 and 2003 were reviewed. Percutaneous access was performed by a group of interventional radiologists (group 1) or a urologist (group 2). An access difficulty score was calculated using patient, stone and procedural variables. Primary outcome measures of percutaneous access complications such as bleeding, failure of access, pneumothorax or other organ injury were compared between groups. Secondary outcome measures of stone-free rates were also compared. RESULTS: In groups 1 and 2, 54 and 49 patients were identified with a total number of tracts of 54 and 60, respectively. Both groups had similar rates of supracostal access. Mean access difficulty scores were similar between groups. Access related complications were significantly higher in the radiology access group (15 vs 5). Stone-free rates were significantly better in the urology access group (86% vs 61%). CONCLUSIONS: Despite similar access difficulty between groups, access related complications were less and stone-free rates were improved during urologist acquired percutaneous access. Urologists instructed in percutaneous access may be able to provide improved stone-free rates during percutaneous nephrolithotomy while minimizing access related complications.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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