Influence of sheath size on suction mini‐PCNL outcomes: An observational study from the EAU endourology section and the global suction in mini‐PCNL collaborative study group
Bibliographic record
Abstract
Abstract Objective We aim to evaluate the association between sheath size and outcomes in suction mini‐percutaneous nephrolithotomy (SM‐PCNL). Materials and Methods A prospective, multicentre study enrolled 1534 patients undergoing SM‐PCNL from March to November 2024 across 30 centres. Patients were stratified into three groups: Group 1 (14–15 Fr, n = 780), Group 2 (16–18 Fr, n = 388), and Group 3 (20–22 Fr, n = 366). Primary outcome was 30‐day stone‐free rate (SFR) determined by non‐contrast CT. Secondary outcomes included complications, operative times and hospital stay. Results Group 3 achieved the highest zero residual fragment rate (92.6%) compared to Groups 2 (80.7%) and 1 (79.5%) ( p < 0.001). Operative times were shortest in Group 3 (36 min) and longest in Group 2 (65 min). Larger sheaths were associated with significantly higher overall complication rates: Group 1 (7.6%), Group 2 (14.4%) and Group 3 (14.8%) ( p < 0.001). Transfusion requirements increased with sheath size: 0% (Group 1), 1.5% (Group 2) and 3.3% (Group 3). Group 3 had exclusive pleural injuries requiring chest tubes (2.7%) and highest pelvicalyceal perforation rates (4.1% vs 1.3% in Group 2, 0% in Group 1). Larger sheath (16/18 Fr: OR 1.82; 21/22 Fr: OR 4.14) and single step dilation (OR 3.84) were associated with higher odds of zero residual fragments. Sheath size 21/22 Fr (OR 2.12) and increasing Guys stone score (score 2: OR 1.94; score 3: OR 3.51; score 4: OR 2.63 95% CI) were factors significantly associated with higher odds of overall complications. Conclusions Sheath selection in SM‐PCNL requires balancing efficacy against safety. Larger sheaths (20–22 Fr) optimize stone clearance but increase complications. Smaller sheaths (14–15 Fr) offer superior safety for simple cases. Intermediate sizes (16–18 Fr) may represent an optimal compromise for moderately complex stones.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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".