Comparative Study Assessing Postoperative Renal Loss Using Two Different Partial Nephrectomy Techniques: Off-Clamp versus Standard On-Clamp Surgery
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Bibliographic record
Abstract
OBJECTIVES: To evaluate a case-matched study comparing postoperative renal function using two surgical techniques: an off-clamp partial nephrectomy (PN) with the aid of the Altrus® device and a standard on-clamp laparoscopic PN. MATERIAL AND METHODS: A total of 36 patients underwent PN. Eighteen had the off-clamp technique and 18 had the standard laparoscopic on-clamp PN. Demographic, clinical, radiological, and perioperative data were collected for analysis. An emphasis on renal function was made by analyzing both the perioperative and follow-up with estimated glomerular filtration rate and MAG3. RESULTS: The median values did not signifcantly differ for age, Charlson Comorbidity Index, and hospital stay in the off-clamp versus on-clamp PN [62.5 (interquartile range, IQR 11) vs. 60 (IQR 16) years, 4 (IQR 2) vs. 5 (IQR 2) and 5 (IQR 1) vs. 4 (IQR 2) days], respectively. The median diameter of the tumors was 33 (IQR 23) versus 41 (IQR 28) mm (p = 0.63), with median R.E.N.A.L. nephrometry scores of 7 (IQR 2) versus 7 (IQR 2) (p = 0.33). There was greater blood loss in the Altrus® (375 vs. 200 ml, p = 0.037). The clamp time in the on-clamp group was 30 (IQR 6) minutes (range 22-68 minutes) compared to 0 minutes in the off-clamp group. There was no difference in hemoglobin or creatinine levels between the groups. However, the on-clamp group had a significant loss in ipsilateral renal function on the MAG3 scan (49 vs. 42%, p = 0.0001), whereas the off-clamp group had no difference (48 vs. 46%, p = 0.72). CONCLUSIONS: The off-clamp method for PN is a feasible and safe option with better preservation of ipsilateral renal function when compared with on-clamp PN in the treatment of small renal masses.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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 | 0.001 |
| 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 it