Predictors of success and complications of monoplanar renal access for conventional prone percutaneous nephrolithotomy
Bibliographic record
Abstract
INTRODUCTION: Our aim was to assess how monoplanar fluoroscopy-guided access affects the outcomes of percutaneous nephrolithotomy (PCNL). METHODS: This retrospective study included all patients who had renal stones and underwent prone PCNL using monoplanar fluoroscopy-guided access in a single tertiary care center between January 2015 and January 2024. Preoperative and postoperative patient- and procedure-related variables, such as operative time, intraoperative blood loss, number of tracts, complications, stone-free rate (SFR), and hospital stay, were assessed. Multivariable analysis was performed to detect predictors of residual stones and complications. RESULTS: A total of 662 patients with an average age of 47±12 years were included. Comorbidities were reported in 26.1%. American Society of Anesthesiologists (ASA) score was I in 64.8%. The mean stone diameter was 2.8±0.9 cm. Only 6% had positive preoperative urine culture. The mean stone Hounsfield unit (HU) was 1054±304 with a mean operative time of 94±31 minutes. Most cases (74.9%) required only one tract. Postoperative fever was reported in 22.4%. The median estimated blood loss (EBL) was 160 mL. The complications included urine leak (4.1%), blood transfusion (1.5%), sepsis (1.5%), renal pelvic perforation (0.8%), superselective angio-embolization (0.6%), pleural injury (0.6%), and colonic injury (0.2%). The median hospital stay was three days. Approximately 73% were stone-free. The only predictor of residual stone was higher stone diameter (odds ratio [OR] 1.536, p=0.001). Predictors of complications were three tracts (OR 4.501, p=0.033) and higher EBL (OR 1.003, p<0.001). CONCLUSIONS: The monoplanar fluoroscopy-guided approach has demonstrated a noteworthy success rate, rendering it a safe modality for prone conventional PCNL.
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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 | 0.004 |
| 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 | 0.001 | 0.001 |
| 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".