BMET-33. MORBIDITY AND MORTALITY OF OMMAYA RESERVOIR PLACEMENT FOR INTRAVENTRICULAR CHEMOTHERAPY
Bibliographic record
Abstract
In 1963, a Pakistani neurosurgeon by the name of Ayub Ommaya proposed a surgical technique for subcutaneous reservoir and pump placement to allow access to intraventricular cerebrospinal fluid (CSF). Currently, the most common indication for Ommaya reservoir insertion in adults is for patients with hematologic or leptomeningeal disorders. We wished to examine short-and-long-term outcomes in patients treated with Ommaya reservoirs at our institution. We retrospectively evaluated all operative cases of Ommaya reservoir insertion from 2000-2014 by the senior author (JFM). Patient demographic data, surgical outcomes, peri-operative complications, and long-term outcomes were collected. 28 patients underwent image-guided Ommaya reservoir insertion by the senior author (JFM) over the study period (43.3 +/- 17.3 years; 35.7% female). The most common indications for placement were acute lymphoblastic leukemia, diffuse large B-cell lymphoma, and leptomeningeal carcinomatosis. There were two complications: one asymptomatic peri-operative intracranial hemorrhage (3.6%), and one early infection (3.6%) requiring catheter removal and intravenous antibiotics. All catheters were accurately placed (100% success rate). Data collection for long-term outcome is currently underway. Our findings suggest minimal short-term morbidity with improved accuracy and decreased complications using an image-guided approach compared with a traditional approach. There were no peri-operative deaths in our series. Our results support routine use of intra-operative image guidance for proximal catheter insertion in elective Ommaya reservoir placement for intraventricular chemotherapy.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.004 | 0.001 |
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".