Does Cardiopulmonary Bypass Affect Outcomes in Nephrectomy with Level III/IV Caval Thrombectomy for Renal Cell Carcinoma?
Bibliographic record
Abstract
Radical nephrectomy with inferior vena cava (IVC) thrombectomy is a technically complex procedure. Cardiopulmonary bypass (CPB) is frequently employed for managing high-level thrombi, yet its impact on surgical outcomes remains uncertain. This study evaluated the outcomes of radical nephrectomy with level III/IV thrombectomy with or without CPB. We retrospectively reviewed records of patients with renal cell carcinoma and level III/IV (Mayo classification) thrombi who underwent open radical nephrectomy and IVC thrombectomy at our center between January 2000 and December 2023. Perioperative and survival outcomes were compared between patients in the CPB and non-CPB groups. Multivariable regression identified clinical factors associated with all-grade complications and survival. Primary and secondary outcomes were 90-day complications and overall survival. Fifty-seven patients were included: 30 (53%) in the CPB group and 27 (47%) in the non-CPB group. Within 90 days, overall complication and mortality rates were 49% and 10.5%; no statistically significant differences were observed between groups. In multivariable models, CPB was not independently associated with 90-day complications (odds ratio [OR] 0.55, 95% CI 0.13–2.12, p = 0.4) or overall survival (hazard ratio [HR] 1.34, 95% CI 0.65–2.78, p = 0.41). In our cohort, we did not find CPB use to independently influence perioperative complications or survival outcomes in radical nephrectomy with level III/IV IVC thrombectomy.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".