An unusual cause of Grade IIIb Clavien complication of percutaneous nephrolithotomy: Broken and retained Malecot nephrostomy catheter
Bibliographic record
Abstract
Percutaneous nephrolithotomy (PCNL) is a relatively safe operation with low rates of major complications. Clavien-Dindo classification is a validated system to record complications, although still needing standardization in reporting and scoring of complex and rare events. We report an unusual adverse incident that required interventional management and impacted the postoperative course. The case of a broken re-entry Malecot nephrostomy catheter as it was being removed on the third postoperative day of an otherwise uneventful PCNL is described. The retained part was removed by open-surgery under general anesthesia. This incident has upgraded the minimally invasive surgery to a Grade IIIb complicated procedure according to the modified Clavien classification. Patient data, procedure conditions, and surgical retrieval of the catheter are detailed. Although far from being life-threatening, this rare complication due to a broken and retained drainage catheter is regarded as a high-grade complication according to the Clavien system.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".