MP59-16 RENAL ARTERY PSEUDOANEURYSMS AFTER NEPHRON SPARING SURGERY FOR RENAL CELL CARCINOMA: INCIDENCE, MANAGEMENT AND FUNCTIONAL OUTCOMES FROM CANADIAN KIDNEY CANCER INFORMATION SYSTEM DATABASE.
Bibliographic record
Abstract
You have accessJournal of UrologyKidney Cancer: Localized IV1 Apr 2014MP59-16 RENAL ARTERY PSEUDOANEURYSMS AFTER NEPHRON SPARING SURGERY FOR RENAL CELL CARCINOMA: INCIDENCE, MANAGEMENT AND FUNCTIONAL OUTCOMES FROM CANADIAN KIDNEY CANCER INFORMATION SYSTEM DATABASE. Rahul Bansal, Anil Kapoor, Antonio Finelli, Ricardo Rendon, Ron Moore, Rodney Breau, Louis Lacombe, Jun Kawakami, Darrel Drachenberg, Peter Black, Stephen Pautler, Zhihui Liu, and Simon Tanguay Rahul BansalRahul Bansal More articles by this author , Anil KapoorAnil Kapoor More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Ricardo RendonRicardo Rendon More articles by this author , Ron MooreRon Moore More articles by this author , Rodney BreauRodney Breau More articles by this author , Louis LacombeLouis Lacombe More articles by this author , Jun KawakamiJun Kawakami More articles by this author , Darrel DrachenbergDarrel Drachenberg More articles by this author , Peter BlackPeter Black More articles by this author , Stephen PautlerStephen Pautler More articles by this author , Zhihui LiuZhihui Liu More articles by this author , and Simon TanguaySimon Tanguay More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1812AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The occurrence of renal artery pseudoaneurysms (RAP) after nephron sparing surgery (NSS) is associated with significant patient morbidity and requires aggressive management. We conducted this study to evaluate the incidence, management and functional outcomes of RAP after NSS. Methods We retrospectively accessed the prospectively maintained Canadian Kidney Cancer information system (CKCis) database for 1066 patients who underwent NSS in 14 centers across Canada. Relevant demographics and clinical data were collected for patients with RAP. Results Sixteen (1.5%) patients presented with RAP. Out of 628 open NSS and 421 laparoscopic or robot-assisted NSS, 8 patients each (1.27% and 1.9% respectively) presented with RAP. Mean patient age was 64.3 years (48.0 – 83.0), BMI 28.2 kg/m2 (18.0 – 35.0), tumor size 3.6 cm (1.5 – 8.0), operative time 167.8 minutes (125 – 221), estimated blood loss 318 ml (50 - 1000) and warm ischemia time was 26.6 minutes (14 - 55). Median length of stay was 4 days (IQR 3.0 – 9.2). Eight (50%) patients had clear cell RCC, 4 (25%) had papillary, 2 (12.5%) had chromophobe and one (6.3%) each had mucinous spindle cell tumor and angiomyolipoma. Median duration of presentation from NSS was 15 days (IQR 11 – 34). Symptoms included hematuria alone in 7 (43.7%), hematuria with flank pain in 5 (31.3%), hematuria with flank swelling in 1 (6.2%), flank pain in 2 (12.5%) and hypotension in one (6.3%). Diagnosis of pseudoaneurysm was made through computerized tomographic angiography and all patients underwent selective embolization of the pseudoaneurysm (Fig. 1). Symptoms were controlled in all patients and there was no recurrence up to a mean follow-up of 22 months (1 – 83). Blood transfusion was required in 4 (25%) patients. Mean serum creatinine levels prior to surgery and at latest follow up were 89.6 μmol/L (50 - 144) and 96.2 μmol/L (57 – 162) respectively. Conclusions Delayed presentation in the form of RAP is a rare complication after NSS with overall incidence of 1.5%. Majority of patients present with hematuria. Management with angiography and selective embolization achieves a high success rate with low impact on overall renal function. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e656 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Rahul Bansal More articles by this author Anil Kapoor More articles by this author Antonio Finelli More articles by this author Ricardo Rendon More articles by this author Ron Moore More articles by this author Rodney Breau More articles by this author Louis Lacombe More articles by this author Jun Kawakami More articles by this author Darrel Drachenberg More articles by this author Peter Black More articles by this author Stephen Pautler More articles by this author Zhihui Liu More articles by this author Simon Tanguay More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
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 | 0.001 | 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 | 0.000 |
| 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 teacher head, 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".