Middle calyx access in complete supine percutaneous nephrolithotomy
Bibliographic record
Abstract
Background: Middle calyx access has been underused in percutaneousnephrolithotomy (PCNL), especially in the supine position.We compared the safety and efficacy outcomes between middlecalyx and lower calyx accesses in the complete supine PCNL in anon-randomized single-surgeon clinical study.Methods: Between February 2008 and October 2011, 170 patientsunderwent posterior subcostal single tract complete supine PCNLwith one-shot dilation and middle calyx (n = 48) and lower calyx(n = 122) accesses. Stone location and surgeon decision determinedtarget calyx for access. Inclusion criteria were pelvis stones,staghorn stones and multiple location stones. Exclusion criteriawere renal anomalies, only upper calyx stones, only middle calyxstones and only lower calyx stones. Important parameters werecompared between the two groups. A p value of <0.05 was consideredsignificant.Results: Two groups were similar in important patient- and stonerelatedparameters. Mean operative time (60.7 minutes), meanpostoperative hospital stay (1.84 days) and mean hemoglobin drop(0.67 g/dL) in the middle calyx group were significantly lesser thanin the lower calyx group (80.1 minutes, 2.19 days, 1.36 g/dL). Themiddle calyx group (89.6%; 79.6%) had a higher stone-free rate(p = 0.054) and efficiency quotient than the lower calyx group(76.2%; 61.6%). In the middle calyx group (10.4%; 2.1%), complicationand transfusion rates were lesser (p > 0.05) than lowercalyx group (14.8%; 7.4%). No significant difference (p = 0.40)was seen between two groups using the modified Clavien classificationof complications.Interpretation: Middle calyx can be an optimal access in PCNLwith the complete supine position for many of upper urinary tractstones due to its superior outcomes.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".