Nephroureterostomy-Drained Percutaneous Nephrolithotomy: Modification Combining Safety with Decreased Morbidity
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: Percutaneous nephrolithotomy (PCNL) has become well established as the standard procedure for the management of certain renal calculi. To minimize patient discomfort and reduce the hospital stay, a novel modification of our previous technique was evaluated. A smaller internal/external nephroureterostomy catheter (NUC) placed at the completion of the procedure was compared with the larger Malecot nephrostomy tube. PATIENTS AND METHODS: We conducted a 2:1 matched cohort study with historical controls. In 2002, a consecutive series of 30 PCNL procedures at a single teaching hospital were carried out in the conventional fashion. At the end of the procedure, an 8.5F/6.0F internal/external NUC was placed in the percutaneous tract instead of the traditional 24F Malecot tube. These patients were compared with a cohort of matched cases (60) performed between 1992 and 1997 on the basis of age, sex, and site of access (supracostal or infracostal). The endpoints were patient discomfort (morphine equivalents used), safety (postoperative hemoglobin drop), and length of hospital stay. RESULTS: The mean morphine equivalents used in the first 24 postoperative hours were significantly different in the two groups (study 16.5 mg and controls 47.8 mg; P<0.001). The percentage difference between the preoperative and postoperative hemoglobin values was comparable in the two groups (mean study 12.8% and mean controls 13.4%; P=0.80). The median length of hospital stay was significantly shorter in the study group than in the control group, 1 v 4 days, respectively (P<0.001). CONCLUSION: Our data suggest that the NUC diminishes postoperative pain while maintaining ureteral patency and nephrostomy access and decreases hospital stay.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| 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 | 0.000 |
| 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".