MP79-16 SUPER PULSE THULIUM FIBER LASER COMPARED TO 120W HOLMIUM:YAG LASER: IMPACT ON RETROPULSION AND LASER FIBER BURN BACK
Bibliographic record
Abstract
INTRODUCTION AND OBJECTIVES: To evaluate the risk factors of systemic inflammatory response syndrome (SIRS) following retrograde intrarenal surgery (RIRS).METHODS: A total of 260 patients who underwent RIRS were included in this retrospective study.21 out of 260 patients who developed postoperative SIRS were categorized as SIRS group and the rest 239 patients were categorized as non-SIRS group.Two-tailed t-test was used to determine significance of change in continuous variables whereas categorical data were compared with the Chi-squared test or Fisher's exact test for proportions.Multivariable logistic regression analysis was performed to identify the potential risk factors of SIRS as after adjusting for covariates that were statistically significant in the univariate analysis.RESULTS: 157 (60.4%) patients were males, and 103(39.6%)patients were females.The mean age was 48.4Æ12.2years and the mean stone burden was 1.7Æ0.7 cm.Preoperative positive midstream urine culture was noted in 47(18.1%patientsand solitary kidney was found in 31(11.9%)patients.The mean lithotripsy time was 34.3Æ13.0minutes and the mean operation time was 45.4Æ12.9minutes.Twenty one (8.1%)patients developed postoperative SIRS.Two patients developed clinical septic shock and recovered after treatment in intensive care unit (ICU).Multivariable logistic regression analysis showed that sex (OR[0.047,95%CI[0.009-0.238,p<0.001), irrigation method (OR[0.059,95%CI[0.008-0.446,p[0.006), access sheath (OR[0.200,95%CI[0.045-0.878,p[0.033), infection stone (OR[3.769,95%CI[0.829-17.134,p[0.086), stone burden (OR [2.789, 95%CI[0.761-10.225,p[0.122), irrigation flow rate (OR[1.240,95%CI[1.137-1.352,p<0.001), and lithotripsy time (OR[0.935,95%CI[0.856-1.021,p[0.133) were identified as independent risk factors of SIRS after RIRS.The equation was: LogitP[-9.404-3.050*Sex-2.826*(Irrigationmethod)-1.611*(Accesssheath)þ1.327*(Infection stone) þ1.026*(Stone burden)þ0.215*(Irrigationflow rate)-0.068*(Lithotripsytime).CONCLUSIONS: Females, infection stone, large stone burden, irrigation with high flow rate, small size access sheath and prolonged operation time were important risk factors of SIRS after RIRS.Syringe injection was regarded as a good method to provide irrigation with low flow rate and low pressure, and larger size access sheath can provide better drainage during RIRS, therefore to be preferred for RIRS procedures.The operation time should be seriously controlled in patients with high risk factors for SIRS, and staged procedures strategy should be preferred.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.015 | 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".