Fate of the Antegrade Ureteric Stent
Bibliographic record
Abstract
Introduction Antegrade stents are commonly used to relieve malignant and benign ureteric obstruction. However, follow up of these patients often involves several specialties and the potential for delayed management and forgotten stents. This observational study reviews indications and outcomes of antegrade stent procedures at one university hospital to provide prognostic and quality improvement data. Patients and Methods A retrospective analysis of 152 antegrade stent procedures in 142 patients over a 27-month period was performed. Cohorts were studied according to underlying pathology, referring specialty and intended duration of stent placement. Measured outcomes were time to stent removal or stent exchange, death, forgotten stents and complications. Results The overall technical success rate of antegrade stent insertion was 98%. Follow-up data was available for 145 successful procedures in 138 patients. Malignancy (47%) and stone disease (35%) were the commonest indications. Overall, 43 patients (31%) died over a median follow up period of 2.2 years. 29 of 64 patients (45%) with malignancy died with stents in situ after a median interval of 3.5 months. Malignancy and unclear intended duration of stent placement were predictors of death with a stent in situ. Twelve patients (9%) had forgotten stents and a strong association with gynaecological malignancy was noted, which is felt to represent inadequate follow up of patients with non-urological pathology. Complications were reported in thirteen patients (9%), including ten cases of heavy stent encrustation and one malpositioned stent. Conclusions Prognostic factors should be considered in the management of patients stented for malignant obstruction, which is usually a marker of advanced disease. The hazards of inadequate follow up are highlighted, causing delays in stent removal and exchange, or the forgotten stent. Interventions are described to minimize these risks.
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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 | 0.000 | 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 | 0.000 |
| 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".